Correlation between Protein to Creatinine Ratio in a Single Urine Sample and Daily Protein Excretion

Villafruela, J.J.; Pascual, Julio; Jl, Teruel; Naya, M. T.; Rivera, María Dolores González; Ortuño, J

doi:10.1159/000418786

Cited by 6 publications

(5 citation statements)

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“…Furthermore, according to Hebert [ 26 ], the random spot urine P/C ratio is unreliable for estimating 24-h proteinuria in individual SLE patients. In contrast our study demonstrated a good correlation between 24-h proteinuria (simple measurement and 24-h P/C ratio) and random P/C ratio among patients with LN, which is in accordance with prior cross-sectional, observational studies performed with other subgroups (pregnant women, kidney transplanted patients and patients with diabetic and non-diabetic nephropathy) [ 31 , 33 – 37 ].…”

Section: Discussionsupporting

confidence: 92%

“…Yet, previous studies suggested that this correlation varies in accordance with different levels of proteinuria [ 31 – 33 , 39 ] and it is worse (or there is none) for proteinuria >3500 mg. In our population, we only observed one patient with proteinuria in the nephrotic range due to an inaugural LN whose results differed greatly between the P/C ratio and 24-h collection, in agreement with previous data.…”

Section: Discussionmentioning

confidence: 92%

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Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?

Marques

Cotovio

Ferrer

et al. 2013

Clinical Kidney Journal

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BackgroundLupus nephritis (LN) is a common and severe manifestation of systemic lupus erythematosus (SLE) that can lead to end-stage renal disease. According to the Kidney Disease Outcomes Global Improving clinical Guidelines for Glomerulonephritis, spot urine protein/creatinine (P/C) ratio should be used for monitoring LN. However, some reports write that the random spot urine P/C ratio is unreliable in monitoring proteinuria in SLE glomerulonephritis patients. The aim of this study was to evaluate the agreement of these two assay methods.MethodsThe prospective observational study was performed. Fifty-three paired (total 106) spot and 24-h urine collections were evaluated. Statistical analysis: SPSS 20.0.ResultsPaired samples t-test did not reveal significant differences between the two-paired assay methods (spot P/C ratio versus 24-h proteinuria and 24-h P/C ratio) and a statistically significant correlation was observed between them: Pearson's coefficient of 0.847 (P < 0.001) and 0.863 (P < 0.001), respectively. However, after stratifying by degrees of proteinuria, a poor correlation was found in the range of <500 mg/day and only 26.6% of 24-h P/C ratio was explained by the spot P/C ratio. Adding to this, for proteinuria range between 500 and 1000 mg/day, there was no correlation (Pearson's −0.098; P > 0.05). In fact, only 1% of 24-h measurements could be explained by the spot P/C ratio.ConclusionsOur study demonstrated a good correlation between 24-h proteinuria and random P/C ratio among patients with LN. However, this correlation was poor for proteinuria under 500 mg/day and did not exist in a range between 500 and 1000 mg/day. This finding is of greater importance because this range is quite common in patients with LN remission. Until further clarification, to the best of our knowledge, we maintain reluctant to completely substitute the 24-h collection by the P/C ratio especially when a renal flare is suspected, or before any change in therapy.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 92%

Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?

Marques

Cotovio

Ferrer

et al. 2013

Clinical Kidney Journal

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“…26 They reported 8 nonrandomized studies with a total of 1871 adult renal transplant patients. [16][17][18][19][20][21][22][23] The correlation between PCR and 24 hour urine protein ranged from 0.77 to 0.99 (median, 0.92) and both the sensitivity and specificity were greater than 80%. The studies included were quite heterogeneous, used different cutoffs, and the timing of measurement after transplantation was also quite variable.…”

Section: Utility Of Acr and Pcrmentioning

confidence: 99%

Evaluation and Management of Proteinuria After Kidney Transplantation

Tsampalieros

Knoll

2015

Transplantation

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Proteinuria occurs commonly after kidney transplantation. Because there are no specific guidelines for defining and detecting proteinuria in transplant recipients, its prevalence can vary depending on the methods used. Most often, the same cutoffs for defining proteinuria in the nontransplant population are applied. There are several risk factors for proteinuria, including some transplant-specific diagnoses and immunosuppressive medications. Posttransplantation proteinuria is associated with reduced graft survival as well as an increased risk of cardiovascular events and death. Treatments to decrease proteinuria have been based on blocking the renin-angiotensin-aldosterone system with the use of angiotensin-converting enzyme inhibitors or angiotensin receptor blockers. This review describes the measurement, prevalence, etiology, prognostic significance, and management of proteinuria in both adult and pediatric transplant recipients.

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“…8,16 Although some studies suggests moderate correlation between spot urine protein creatinine ratio and 24 hour urinary protein excretion , [17][18] but the results of those studies are variable in accordance with different levels of proteinuria. 8,15,[19][20] This study was carried out to determine whether the protein creatinine ratio in random urine sample, is a convenient, quick and reliable method for the estimation of proteinuria in diagnosing and monitoring Nephrotic syndrome in children, as it avoids collection error and may give more relevant information.…”

Section: Introductionmentioning

confidence: 99%

Correlation between 24-hour Urinary Total Protein Excretion and Single Urinary Protein Creatinine ratio in the Diagnosis of Childhood Nephrotic Syndrome : Study in a Tertiary Level Hospital

Anowar

Sarker

Mahamuduzzaman

et al. 2023

J Shaheed Suhrawardy Med Coll

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Introduction:Protein excretion varies in the course of the day, for this reason 24-hours urinary total protein excretion has been considered as the classic reference method for protein determination in nephotic syndrome. As the collection of urine for 24 hours is tedious and errors may occur during the process, so the protein:creatinine ratio was developed as a diagnostic alterative for Nephrotic syndrome.The main aim of this study is to determine the correlation between 24-hour urinary total protein excretion and single urinary protein creatinine ratio in childhood Nephrotic syndrome. Methods: This cross-sectional study was conducted in the department of Paediatrics,Shaheed Suhrawardy Medical College & Hospital from June 2018 to May 2019. After taking valid consent total 60 cases of Nephrotic syndrome were selected purposively according to inclusion and exclusion criteria. Here we tried to determine the correlation between 24-hour urinary total protein excretion and single urinary protein creatinine ratio in the diagnosis of childhood Nephrotic syndrome by measuring the spot urinary protein creatinine ratio and the 24 hours urinary total protein excretion of the patients. Results : Among total 60(N) children of Nephrotic syndrome 42 (70%) patients were male and 18 (30%) patients were female with M:F = 2.16:1.The mean age was 4.57 ± 2.01SD years. Most of the patients were presented with some associated diseases like urinary tract infection (30%), upper respiratory tract infection (28.3%), viral illness(8.3%), atopic dermatitis(3.3%) and nonspecific illnesses(30%). The main physical findings were only puffy face(100%), with ascites (86.6%) and swelling of genitalia (38.3%).The mean 24 hours urinary total protein excretion was 3114.45 ± 1627.89 mg/24 hours and spot urinary protein creatinine ratio was 5.57 ± 3.13 SD. There was a very significant correlation between 24 hour total urinary protein excretion and spot urinary protein creatinine ratio. The sensitivity of the study was 80.49 – 100% and specificity of 91.78 - 100% at £2000 mg /sqm body surface area/ day protein excretion. The p value was .002 with correlation coefficient was 0.39. Conclusion: The protein creatinine ratio of a random urine sample might be used as an alternative method for the diagnosis of Nephrotic syndrome in children in view of the obvious advantages in terms of cost, time and patient convenience. J Shaheed Suhrawardy Med Coll 2021; 13(2): 137-142

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Correlation between Protein to Creatinine Ratio in a Single Urine Sample and Daily Protein Excretion

Cited by 6 publications

References 0 publications

Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?

Random spot urine protein/creatinine ratio: a reliable method for monitoring lupus nephritis?

Evaluation and Management of Proteinuria After Kidney Transplantation

Correlation between 24-hour Urinary Total Protein Excretion and Single Urinary Protein Creatinine ratio in the Diagnosis of Childhood Nephrotic Syndrome : Study in a Tertiary Level Hospital

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