Comparative Analysis of Proteinuria by Protein Creatinine Ratio and 24 H Urinary Protein Excretion in Renal Patients

Abstract

BACKGROUND The Kidney Disease Outcomes Quality Initiative (K/DOQI) of the National Kidney Foundation Practice Guideline as well as American Diabetes Association (ADA) recommends spot urine protein creatinine ratio (UPCR) proteinuria to assess proteinuria. This study was undertaken to evaluate the correlation of UPCR with 24-hour urine for estimation of proteinuria in patients with different aetiology for renal failure. METHODS This retrospective study was conducted in tertiary care renal referral hospital between December 2018 and May 2019 Patients enrolled in the study were diagnosed with renal failure due to different causes. The patients with incomplete data, having oliguria and inadequate urine collection were excluded from the study. The urine protein and creatinine concentration of both 24 h and spot urine were evaluated. RESULTS Among 74 patients enrolled in the study, the majority of cases were diagnosed with diabetic nephropathy (48.60%), followed by IgA nephropathy (16.10%) and rest of the patients (35.30%) with other renal diseases. The mean 24 h urine protein concentration was 2270.68 mg/day. The mean spot urine creatinine concentration was 96.2 mg/dL and mean spot protein concentration was 197.97 mg/dL. UPCR and 24 h urine protein estimation had strong correlation with r = 0.846 and p < 0.001 with Pearson's correlation analysis. CONCLUSIONS Spot/random UPCR is a reliable method to estimate urinary protein excretion. It can be an alternative to 24 h urine collection especially in renal patients particularly in children, elderly and pregnant women.