Comparison of 24 Hour Urinary Protein and Spot Urinary Protein- Creatinine Ratio in the Assessment of Proteinuria in Patients with Glomerulonephritis

Ahmed, Parvez Iftekhar; Islam, Nazrul; Alam, Babrul; Bhuiya, Ferdous Kamal; Noman, Mesbah Uddin; Chowdhury, Nizamuddin

doi:10.3329/jdmc.v23i2.25390

Cited by 5 publications

(13 citation statements)

References 19 publications

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“…A spot urine P/C ratio value of 20 mg/mmol (0.2 mg/ mg) is the most frequently reported cutoff point for determining the presence or absence of proteinuria, and a P/C ratio of 350 mg/mmol (3.5 mg/mg) is used for 5. Limitations of the spot urine P/C ratio evaluation [5,21,29,33,39,45,54,92,93,101,[113][114][115][116].…”

Section: Discussionmentioning

confidence: 99%

“…It is worth noting that not all patients with CKD have proteinuria, whereas its presence allows the identification of patients who are at significantly more risk of disease progression. Literature data confirms that the evaluation of the P/C ratio in a single urine sample is a good alternative to a 24-h urine collection for the assessment of proteinuria, especially in patients with renal insufficiency [17,21,27,54].…”

Section: Spot Urine P/c Ratio and Kidney Diseasesmentioning

confidence: 92%

“…In turn, Kristal et al found a high correlation of spot urine P/C ratio results with protein excretion in 24-h urine collections and observed that it did not depend on the severity of proteinuria, while it was slightly dependent on the glomerular filtration rate [16]. In a study conducted by Ahmed et al, in the group of patients with different types of glomerulonephritis, positive correlations of spot urine P/C ratio results with protein concentrations in 24-h urine collections were found in relation to GFR values [21]. A high degree of correlation (r ¼ 0.987) between these two results was observed in patients with GFR in the range of 30-59 ml/ min/1.73m 2 , while moderate correlation (r ¼ 0.535) was seen in patients with advanced renal failure (GFR < 15 ml/min/1.73m 2 ).…”

Section: Spot Urine P/c Ratio and Kidney Diseasesmentioning

confidence: 94%

“…However, our review of the literature demonstrated the diversity of methods used to assess the spot urine P/C ratio, which may result in variable determinations between laboratories. Some publications lacked information on the protein and creatinine assessment methods used to calculate the P/C ratio [2,7,21].…”

Section: Methods Of Protein and Creatinine Evaluationmentioning

confidence: 99%

“…In addition, the authors found the following correlations of the spot urine P/C ratio with protein concentration in 24-h urine collections in the following ranges: <0.2 g/d (r ¼ 0.721); 0.2-1.0 g/d (r ¼ 0.788); 1.0-3.4 g/d (r ¼ 0.688); 3.5-6.0 g/d (r ¼ 0.728). Ahmed et al emphasized that they did not observe a correlation between these tests when the protein excretion reached values above 6 g/d [21]. Ali et al divided the patients whose protein concentrations exceeded 0.5 g/d into five subgroups depending on their GFR values based on the ranges used to classify CKD; they found a significant positive correlation between the spot urine P/C ratios and the protein concentrations in 24-h urine collections regardless of the GFR value (r ¼ 0.80 to r ¼ 0.96).…”

Section: Spot Urine P/c Ratio and Kidney Diseasesmentioning

confidence: 97%

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Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine sample within routine clinical practice

Kamińska

Dymicka-Piekarska

Tomaszewska

et al. 2020

Critical Reviews in Clinical Laboratory Sciences

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The spot (random) urine protein to creatinine ratio (P/C ratio) is an alternative, fast and simple method of detecting and estimating the quantitative assessment of proteinuria. The aim of the work was to review the literature concerning the usefulness of spot urine P/C ratio evaluation in the diagnosis of proteinuria in the course of kidney disease, hypertension, gestational hypertension, preeclampsia, immunological diseases, diabetes mellitus, and multiple myeloma, and in the diagnosis of proteinuria in children. We searched the PubMed and Google Scholar databases using the following keywords: proteinuria, spot urine protein to creatinine ratio, spot urine P/C ratio, protein creatinine index, PCR (protein to creatinine ratio), P/C ratio and methods, Jaffe versus enzymatic creatinine methods, urine protein methods, spot urine protein to creatinine ratio versus ACR (albumin to creatinine ratio), proteinuria versus albuminuria, limitations of the P/C ratio. More weight was given to the articles published in the last 10-20 years. A spot urine P/C ratio >20 mg/mmol (0.2 mg/mg) is the most commonly reported cutoff value for detecting proteinuria, while a P/C ratio value >350 mg/mmol (3.5 mg/mg) confirms nephrotic proteinuria. The International Society for the Study of Hypertension in Pregnancy recommends a P/C ratio of 30 mg/mmol (0.3 mg/mg) for the classification of proteinuria in pregnant women at risk of preeclampsia. A high degree of correlation was observed between P/C ratio values and the protein concentration in 24-h urine collections. The spot urine P/C ratio is a quick and reliable test that can eliminate the need for a daily 24-h urine collection. However, in doubtful situations, it is still recommended to assess proteinuria in a 24-h urine collection. The literature review indicates the usefulness of the spot P/C ratio in various disease states; therefore, this test should be available in every laboratory. However, the challenge for the primary care physician is to know the limitations of the methods used to determine the protein and creatinine concentrations that are used to calculate the P/C ratio. Moreover, the P/C ratio cutoff used should be determined in individual laboratories because it depends on the patient population and the laboratory methodologies.

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