Can spot urine protein/creatinine ratio replace 24 h urine protein in usual clinical nephrology?

Lane, Cathie; Brown, Mark; Dunsmuir, William T. M.; Kelly, John; Mangos, George

doi:10.1111/j.1440-1797.2006.00564.x

Cited by 71 publications

(44 citation statements)

References 16 publications

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“…Thus, Gai et al 27 in predicting a 24 h urine protein loss .150 mg from a PCR 11.3 mg/mmol, obtained sensitivities and specificities of 91% and 75%, respectively. Similarly Lane et al, 30 using thresholds of between 300 mg/L and 3.0 g/L to define abnormal 24 h proteinuria, obtained sensitivities between 85% and 93% and specificities between 80% and 91% at varying PCR cut-offs.…”

Section: Discussionmentioning

confidence: 99%

Protein and albumin-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease

Guy

Borzomato

Newall³

et al. 2009

Ann Clin Biochem

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Background: Random urine protein-to-creatinine (PCR) and albumin-to-creatinine (ACR) ratios have been proposed as alternatives to 24 h urine measurements to simplify sample collection and overcome errors. The aim of this study was to examine the ability of PCR and ACR to predict urinary 24 h protein and albumin loss, respectively, in patients with kidney disease, and determine the most appropriate time of collection. Methods: Eighty-three patients were recruited from a renal outpatient clinic. In a 24 h period, each collected an early-morning urine (EMU), second and third voids, and the remaining urine passed that day. PCR and ACR were determined in random urines and compared with the 24 h loss of protein and albumin, respectively. Results: For all patients, median (range) 24 h urine protein and albumin losses were 220 (30-15600) and 60 (,8 -10,557) mg, respectively. Ratios derived from each of three random urines correlated well with 24 h protein or albumin loss (Spearman's r s . 0.87, P , 0.0001). Receiver operator characteristic (ROC) curve analysis showed PCR accurately predicted both an abnormal 24 h urine protein 150 mg/24 h (areas under curves [AUC] 0.90-0.92) and significant proteinuria above 300 mg/ 24 h (AUC between 0.97 and 1.00). ACR accurately predicted both an abnormal 24 h urine albumin 30 mg/24 h (AUC 0.98 to 0.99) and frank albuminuria at 300 mg/24 h or 700 mg/24 h (AUC between 0.99 and 1.00). EMU and random urines performed equally well in predicting proteinuria and albuminuria from PCR and ACR, respectively. Conclusions: By careful choice of cut-offs, both PCR and ACR can be used in patients with kidney disease to rule in or rule out abnormal 24 h losses of protein and albumin. EMU and, importantly, random samples can be used as surrogates for 24 h urine collections.

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Section: Discussionmentioning

confidence: 99%

Protein and albumin-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease

Guy

Borzomato

Newall³

et al. 2009

Ann Clin Biochem

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“…First, the morning spot urine sample might not be appropriate to represent total sIgA secretion in urine; however, it is well accepted that protein/creatinine ratio in spot urine may represent 24-h proteinuria [20][21][22], therefore it is rational to use the sIgA/ creatinine ratio to reflect total sIgA secretion in urine. Secondly, the best way to evaluate disease progression in the histopathology of patients with IgAN is to perform repeat renal biopsy periodically when patients have signs of disease progression clinically; however, repeat renal biopsy is not acceptable clinically.…”

Section: R-value P-valuementioning

confidence: 99%

The level of urinary secretory immunoglobulin A (sIgA) of patients with IgA nephropathy is elevated and associated with pathological phenotypes

Tan

Zhang

Liu

et al. 2009

Clinical and Experimental Immunology

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SummaryRecent studies have demonstrated deposition of secretory immunoglobulin A (sIgA) in glomeruli of some patients with IgA nephropathy (IgAN). The aim of this study is to investigate the levels of urinary sIgA in IgAN patients with different pathological phenotypes and whether it could be used as a noninvasive biomarker for assessment of kidney injury in IgAN. Urine samples from 202 patients with IgAN were collected on the day of renal biopsy. Forty-eight fulfilled the histopathological criteria of Haas-I or II (group 1), 60 fulfilled Haas-III (group 2) and 94 patients fulfilled Haas-IV or V (group 3). Urine samples from 60 healthy sex-and age-matched volunteers with negative urinalysis were collected as normal controls. Urinary sIgA was detected by sandwich enzyme-linked immunosorbent assay and was corrected by urinary creatinine. In comparison with normal controls, the levels of urinary sIgA were significantly higher in IgAN [2·22 (0-43·82) mg/mg Cr versus 1·08 (0-16·49) mg/mg Cr, P < 0·001]. The levels of urinary sIgA were significantly higher in group 3 than that in group 2 and group 1 [3·54 (0-43·82) mg/mg Cr versus 1·63 (0-15·88) mg/mg Cr versus 0·91 (0-11·79), P < 0·001], and group 2 than group 1 (P = 0·014). The levels of urinary sIgA were associated positively with proteinuria (r = 0·443, P < 0·001), serum creatinine (r = 0·376, P < 0·001) and histopathological parameters, such as ratio of global sclerosis (r = 0·356, P < 0·001), ratio of total crescents (r = 0·339, P < 0·001) and ratios of cellular crescents (r = 0·231, P < 0·001). The levels of urinary sIgA were associated closely with histopathological phenotypes of IgAN and might be used as a non-invasive biomarker to evaluate kidney injury in IgAN.

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“…(5), (6), (7), (8) The NKF K/DOQI guidelines suggests that untimed spot urine samples should be used to detect and monitor proteinuria in children and adults, it prefers a first-morning sample, but accepts a random sample if a first-morning specimen is not available. Few studies have previously assessed agreements rather than correlations between these tests and found wide limits.…”

Section: Discussionmentioning

confidence: 99%

A Study To Determine The Protein To Creatinine Ratio In Random Urine Sample To Predict The Protein Loss In 24 Hours Urine In Cases Of Chronic Kidney Disease In South Indian Population

Ms.Meghalatha.T.S¹

2013

IOSR-JDMS

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Can spot urine protein/creatinine ratio replace 24 h urine protein in usual clinical nephrology?

Abstract: Random spot urinary P/Cr predicts actual 24 h protein excretion with reasonable accuracy in patients with lower levels of protein excretion but is unreliable in patients with high protein excretion and should not be used in the clinical setting unless 24 h urine collection is unavailable.

Cited by 71 publications

References 16 publications

Protein and albumin-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease

Protein and albumin-to-creatinine ratios in random urines accurately predict 24 h protein and albumin loss in patients with kidney disease

The level of urinary secretory immunoglobulin A (sIgA) of patients with IgA nephropathy is elevated and associated with pathological phenotypes

A Study To Determine The Protein To Creatinine Ratio In Random Urine Sample To Predict The Protein Loss In 24 Hours Urine In Cases Of Chronic Kidney Disease In South Indian Population

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