Volume : 7, Issue : 3, March - 2018

Advantage of Spot Urine Protein Creatinine Ratio over 24 Hour Urine Protein for Proteinuria assessment

Dr. U. Sarada, Dr. A. Padma Vijayasree

Abstract :

<p>&nbsp;<b style="text-align: justify;"><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">Background</span></b><b style="text-align: justify;"><span style="font-size:12.0pt;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">: </span></b><span style="text-align: justify; font-family: Arial, sans-serif;">Proteinuria is a common finding in patients with kidney disease and its presence suggests a poor prognosis. The detection and accurate quantification of protein excretion are key diagnostic and prognostic tools for management of many renal disorders.</span></p> <div class="WordSection1"> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;4.05pt;mso-line-height-rule:exactly;mso-pagination:none;mso-layout-grid-align:&#10;none;text-autospace:none"><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">&nbsp;</span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:21.0pt;margin-bottom:&#10;0in;margin-left:21.0pt;margin-bottom:.0001pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:117%;mso-pagination:none;mso-layout-grid-align:&#10;none;punctuation-wrap:simple;text-autospace:none"><b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">Aim and Objective</span></b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">: The main objective of our study was to evaluate the advantage and standardise the method of spot (random) urine protein creatinine ratio (UP/C) over 24 hours urine protein for estimation of proteinuria. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:21.0pt;margin-bottom:&#10;0in;margin-left:21.0pt;margin-bottom:.0001pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:117%;mso-pagination:none;mso-layout-grid-align:&#10;none;punctuation-wrap:simple;text-autospace:none"><b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">Materials and Methods</span></b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">: The study contained 100 study participants in a tertiary care hospital inclusive of 50 cases and 50 normal volunteers. The 24 hour urine protein estimation was done on 24 hour urine samples and UP/C ratio was calculated on random urine samples.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;1.65pt;mso-line-height-rule:exactly;mso-pagination:none;mso-layout-grid-align:&#10;none;text-autospace:none"><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">&nbsp;</span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:21.0pt;margin-bottom:&#10;0in;margin-left:21.0pt;margin-bottom:.0001pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:109%;mso-pagination:none;mso-layout-grid-align:&#10;none;punctuation-wrap:simple;text-autospace:none"><b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">Results</span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">: UP/C ratio and 24 hour urine protein estimation had strong correlation with <i>r</i> = 0.9 and <i>p</i> &lt; 0.05 on Pearson&rsquo;s correlation analysis. Receiver operating characteristic analysis showed random UP/C ratio of 0.1171 reliably predicted 24 hour urine total protein equivalent of &gt;150 mg/24 hrs with sensitivity 100%, specificity 98.1%, positive likelihood ratio 53.5, and negative likelihood ratio 0. UP/C ratio of 3.2 reliably predicted nephrotic range proteinuria at 24 hour urine protein equivalent of &gt;3.5 g/24 hrs with sensitivity 80%, specificity 100%, positive likelihood ratio 154.4, and negative likelihood ratio 0.2.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-bottom:0in;margin-bottom:.0001pt;line-height:&#10;2.4pt;mso-line-height-rule:exactly;mso-pagination:none;mso-layout-grid-align:&#10;none;text-autospace:none"><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">&nbsp;</span></p> <p class="MsoNormal" style="margin-top:0in;margin-right:22.0pt;margin-bottom:&#10;0in;margin-left:21.0pt;margin-bottom:.0001pt;text-align:justify;text-justify:&#10;inter-ideograph;line-height:112%;mso-pagination:none;mso-layout-grid-align:&#10;none;punctuation-wrap:simple;text-autospace:none"><b><span style="font-family:&#10;&quot;Arial&quot;,&quot;sans-serif&quot;">Conclusion</span></b><span style="font-family:&quot;Arial&quot;,&quot;sans-serif&quot;">: We conclude that spot/random UP/C ratio is a reliable, simple test to be introduced and adopted in routine practice for monitoring of macro proteinuria.<o:p></o:p></span></p> </div> <p><span style="font-size:11.0pt;line-height:112%;font-family:&quot;Arial&quot;,&quot;sans-serif&quot;;&#10;mso-fareast-font-family:&quot;Times New Roman&quot;;mso-fareast-theme-font:minor-fareast;&#10;mso-ansi-language:EN-US;mso-fareast-language:EN-US;mso-bidi-language:TE">< clear="all" style="page-eak-before:always;mso-eak-type:section-eak" /> </span></p>