Documentation, Codebook, and Frequencies
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1 Documentation, Codebook, and Frequencies Urinary Albumin and Urinary Creatinine Laboratory Survey Years: 2005 to 2006 SAS Transport File: ALB_CR_D.XPT November 2007
2 NHANES Data Documentation Laboratory Assessment: Urinary Albumin and Urinary Creatinine (ALB_CR_D) First Published: November 2007 Last Revised: N/A Component Description Urinary albumin is measured. Related survey questionnaire data include information on analgesic product use and incontinence. Urinary creatinine is measured. Urine creatinine concentrations from these specimens have been used (instead of a 24-hour volume correction) to correct for the degree of dilution or concentration of some of the urine analytes, such as the phenols or microalbumin. Eligible Sample Participants aged 6 years and older. Description of Laboratory Methodology Urinary albumin A solid-phase fluorescent immunoassay for the measurement of human urinary albumin is described by Chavers et al. (1). The fluorescent immunoassay is a non-competitive, double-antibody method for the determination of human albumin in urine. Antibody to human albumin is covalently attached to derivatized polyacrylamide beads. The solidphase antibody is reacted with a urine specimen, and the urine albuminantigen complexes with the solid-phase antibody. This complex then reacts with fluorescein-labeled antibody. The unattached fluorescent antibody is then removed by washing during centrifugation. The fluorescence of the stable solid-phase antibody complex is determined with a fluorometer; the fluorescence is directly proportional to the amount of urine albumin present. The standard curve is μg/ml of albumin. Increased microalbuminuria is a sign of renal disease and may be predictive of nephropathy risk in patients with insulin-dependent diabetes. Results of the fluorescent immunoassay (FIA) are reproducible, and the test is accurate and sensitive for the detection of human urinary albumin excretion. It is especially useful for the measurement of low levels of urinary albumin not detectable by dipstick methods. The FIA assay resembles the radio-immunoassay (RIA) in technique and sensitivity without the potential health hazards associated with the handling of isotopes in the laboratory (1). Urinary Albumin and Urinary Creatinine (ALB_CR_D) 1
3 Urinary Creatinine Creatinine analysis uses a Jaffé rate reaction, in which creatinine reacts with picrate in an alkaline solution to form a red creatinine-picrate complex. The reaction is measured with a CX3 analyzer. The rate of the color development is measured 25.6 sec after sample injection at 520 and 560 nm. The rate difference between the two wavelengths is proportional to the concentration of creatinine in the reaction cup. The procedures described below are the standard protocols of the Fairview University Medical Center (2 6). Creatinine, the waste product derived from creatine, is released into the plasma at a relatively constant rate. The amount of creatinine per unit of muscle mass is constant; therefore, creatinine is the best indicator of impaired kidney function. There were no changes to the equipment, lab method, or lab site from the previous 2 years. A detailed description of the laboratory method used can be found on the NHANES website. Laboratory Quality Control and Monitoring The NHANES quality control and quality assurance protocols (QA/QC) meet the 1988 Clinical Laboratory Improvement Act mandates. Detailed quality control and quality assurance instructions are discussed in the NHANES Laboratory/Medical Technologists Procedures Manual (LPM). Read the LABDOC file for detailed QA/QC protocols. A detailed description of the quality assurance and quality control procedures can be found on the NHANES website. Data Processing and Editing Urine specimens are processed, stored and shipped to University of Minnesota, Minneapolis, MN. Detailed specimen collection and processing instructions are discussed in the NHANES LPM. Read the LABDOC file for detailed data processing and editing protocols. The analytical methods are described in the Analytic methodology section. Randomly collected or spot urine specimens were collected by cleancatch technique into sterile 250-mL polyethylene containers (from a large production lot, previously prescreened for trace element contamination. Detailed instructions on specimen collection and processing can be found on the NHANES website. Urinary Albumin and Urinary Creatinine (ALB_CR_D) 2
4 Analytic Notes The analysis of NHANES laboratory data must be conducted with the key survey design and basic demographic variables. The NHANES Questionnaire Data Files contain demographic data, health indicators, and other related information collected during household interview and MEC examination. They also contain sample weights for these age groups. The phlebotomy file includes auxiliary information, such as the conditions precluding venipuncture. The household questionnaire and phlebotomy files may be linked to the laboratory data file using the unique survey participant identifier SEQN. References 1. Chavers BM, Simonson J, Michael AF. A solid-phase fluorescent immunoassay for the measurement of human urinary albumin. Kidney Int. 1984;25: Creatinine Measurement Module Operating and Service Instructions, Beckman ASTRA. Brea (CA): Beckman Instruments, Inc., Operating and Service Instructions, Beckman ASTRA. Brea (CA): Beckman Instruments, Inc., Maintenance Guide, Beckman ASTRA. Brea (CA): Beckman Instruments, Inc., Tietz NW, editor, Textbook of Clinical Chemistry. Philadelphia: WB Saunders Company, 1986; Kaplan LA, Pesce AJ, editors, Clinical Chemistry Theory, Analysis and Correlation. St. Louis: CV Mosby Company, 1984: Urinary Albumin and Urinary Creatinine (ALB_CR_D) 3
5 Locator Fields Title: Urinary Albumin and Creatinine Contact Number: NCHS Years of Content: First Published: November 2007 Revised: N/A Access Constraints: None Use Constraints: None Geographic Coverage: National Subject: Urinary Albumin and Creatinine Record Source: NHANES Survey Methodology: NHANES is a stratified multistage probability sample of the civilian non-institutionalized population of the U.S. Medium: NHANES Web site; SAS transport files Urinary Albumin and Urinary Creatinine (ALB_CR_D) 4
6 National Health and Nutrition Examination Survey Codebook for Data Production ( ) Laboratory Section: Urinary Albumin and Urinary Creatinine (ALB_CR_D) November 2007
7 SEQN SEQN English Text: Respondent sequence number. Respondent sequence number URXUMA URXUMA English Text: Albumin, urine (ug/ml) Albumin, urine (ug/ml) Code or Value Description Count Cumulative Skip to Item 0.3 to Range of Values At or below detection limit fill value Missing
8 URXUMS URXUMS English Text: Albumin, urine (mg/l) Albumin, urine (mg/l) Code or Value Description Count Cumulative Skip to Item 0.3 to Range of Values At or below detection limit fill value Missing URXUCR URXUCR English Text: Creatinine, urine (mg/dl) Creatinine, urine (mg/dl) Code or Value Description Count Cumulative Skip to Item 5 to 678 Range of Values Missing
9 URXCRS URXCRS English Text: Creatinine, urine (umol/l) Creatinine, urine (umol/l) Code or Value Description Count Cumulative Skip to Item 442 to Range of Values Missing
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