{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:40Z","timestamp":1785542440588,"version":"3.56.0"},"reference-count":20,"publisher":"Walter de Gruyter GmbH","issue":"3","license":[{"start":{"date-parts":[[2022,1,13]],"date-time":"2022-01-13T00:00:00Z","timestamp":1642032000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,2,23]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_cclm-2021-0912_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Quantification of 24\u00a0h-proteinuria is the gold standard for diagnosing, staging, and monitoring of patients with renal AL amyloidosis. However, 24\u00a0h-urine collection is cumbersome and may result in preanalytical error. In this prospective study, we investigated the role of urinary albumin\/creatinine ratio (UACR) (cut-off: 300\u00a0mg\/g) identifying renal involvement, evaluated a UACR-based staging system (UACR cut-off: 3,600\u00a0mg\/g) and assessed whether UACR response (UACR decrease &gt;30% without worsening in eGFR &gt;25%) predicts renal outcome in 531 patients with newly-diagnosed AL amyloidosis.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0912_abs_002\">\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>From October 2013 paired 24\u00a0h-proteinuria and UACR (on first morning void) were measured in all newly-diagnosed patients with AL amyloidosis. Correlation between 24\u00a0h-proteinuria and UACR at baseline was assessed by Pearson\u2019s r test. Impact of UACR response on renal outcome was assessed in randomly created testing (n=354) and validation (n=177) cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0912_abs_003\">\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A strong linear correlation was found between 24\u00a0h-proteinuria and UACR at baseline (r=0.90; p&lt;0.001). After a median follow-up of 31\u00a0months, 57 (11%) patients required dialysis. A UACR-based renal staging system identified three stages with significantly higher dialysis rate at 36\u00a0months comparing stage I with stage II and stage II with stage III. Achieving a renal response, according to a UACR-based criterion, resulted in lower dialysis rate in both testing and validation cohorts.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_cclm-2021-0912_abs_004\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>UACR is a reliable marker for diagnosis, prognosis, and organ response assessment in renal AL amyloidosis and can reliably replace 24\u00a0h-proteinuria in clinical trials and individual patients\u2019 management.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/cclm-2021-0912","type":"journal-article","created":{"date-parts":[[2022,1,12]],"date-time":"2022-01-12T06:51:30Z","timestamp":1641970290000},"page":"386-393","source":"Crossref","is-referenced-by-count":17,"title":["Prospective urinary albumin\/creatinine ratio for diagnosis, staging, and organ response assessment in renal AL amyloidosis: results from a large cohort of patients"],"prefix":"10.1515","volume":"60","author":[{"given":"Marco","family":"Basset","sequence":"first","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Milani","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia Valeria","family":"Ferretti","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biometry Service, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mario","family":"Nuvolone","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Foli","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Benigna","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Nanci","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margherita","family":"Bozzola","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Ripepi","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melania","family":"Sesta","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) , Policlinico San Matteo , Pavia , Italy"},{"name":"Department of Molecular Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Russo","sequence":"additional","affiliation":[{"name":"Department of Public Health, Experimental and Forensic Medicine , University of Pavia , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiziana","family":"Bosoni","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Klersy","sequence":"additional","affiliation":[{"name":"Clinical Epidemiology and Biometry Service, Fondazione IRCCS Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Riccardo","family":"Albertini","sequence":"additional","affiliation":[{"name":"Laboratory of Clinical Chemistry, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo , Pavia , Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giampaolo","family":"Merlini","sequence":"additional","affiliation":[{"name":"Amyloidosis Research and Treatment Center, Foundation 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