Estimated Protein Excretion Rate From Second Morning Spot Urine Protein-Creatinine Ratio: A Diagnostic Study in Kidney Transplant Recipients.

2014 ◽  
Vol 98 ◽  
pp. 564
Author(s):  
M. Mrevlje ◽  
J. Lindic ◽  
G. Mlinsek ◽  
A. Kandus ◽  
M. Arnol
Keyword(s):  
Kidney Transplant ◽  
Excretion Rate ◽  
Diagnostic Study ◽  
Creatinine Ratio ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Urine Protein ◽  
Spot Urine ◽  
Protein Excretion

scholarly journals First and second morning spot urine protein measurements for the assessment of proteinuria: a diagnostic accuracy study in kidney transplant recipients

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Maja Mrevlje ◽  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Jelka Lindič ◽  
Jadranka-Buturović-Ponikvar ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Urine Protein ◽  
Cross Sectional ◽  
Spot Urine ◽  
Protein Excretion ◽  
Measures Of Agreement

Abstract Background Quantification of proteinuria in kidney transplant recipients is important for diagnostic and prognostic purposes. Apart from correlation tests, there have been few evaluations of spot urine protein measurements in kidney transplantation. Methods In this cross-sectional study involving 151 transplanted patients, we investigated measures of agreement (bias and accuracy) between the estimated protein excretion rate (ePER), determined from the protein-to-creatinine ratio in the first and second morning urine, and 24-h proteinuria and studied their performance at different levels of proteinuria. Measures of agreement were reanalyzed in relation to allograft histology in 76 patients with kidney biopsies performed for cause before enrolment in the study. Results For ePER in the first morning urine, percent bias ranged from 1 to 28% and accuracy (within 30% of 24-h collection) ranged from 56 to 73%. For the second morning urine, percent bias ranged from 2 to 11%, and accuracy ranged from 71 to 78%. The accuracy of ePER (within 30%) in first and second morning urine progressively increased from 56 and 71% for low-grade proteinuria (150–299 mg/day) to 60 and 74% for moderate proteinuria (300–999 mg/day), and to 73 and 78% for high-grade proteinuria (≥1000 mg/day). Measures of agreement were similar across histologic phenotypes of allograft injury. Conclusions The ability of ePER to accurately predict 24-h proteinuria in kidney transplant recipients is modest. However, accuracy improves with an increase in proteinuria. Given the similar accuracy of ePER measurements in first and second morning urine, second morning urine can be used to monitor protein excretion.

scholarly journals First and Second Morning Spot Urine Protein Measurements for the Assessment of Proteinuria: A Diagnostic Accuracy Study in Kidney Transplant Recipients

2021 ◽  
Author(s):  
Maja Mrevlje ◽  
Manca Oblak ◽  
Gregor Mlinšek ◽  
Jadranka Buturović-Ponikvar ◽  
Jelka Lindič ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Cross Sectional Study ◽  
Low Grade ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Urine Protein ◽  
Cross Sectional ◽  
Spot Urine ◽  
Protein Excretion ◽  
Measures Of Agreement

Abstract Background. Quantification of proteinuria in kidney transplant recipients is important for diagnostic and prognostic purposes. Apart from correlation tests, there have been few evaluations of spot urine protein measurements in kidney transplantation.Methods. In this cross-sectional study involving 151 transplanted patients, we investigated measures of agreement (bias and accuracy) between the estimated protein excretion rate (ePER), determined from the protein-to-creatinine ratio in the first and second morning urine, and 24-hour proteinuria and studied their performance at different levels of proteinuria. Measures of agreement were reanalyzed in relation to allograft histology in 76 patients with kidney biopsies performed for cause before enrolment in the study.Results. For ePER in the first morning urine, percent bias ranged from 1% to 28% and accuracy (within 30% of 24-hour collection) ranged from 56% to 73%. For the second morning urine, percent bias ranged from 2% to 11%, and accuracy ranged from 71% to 78%. The accuracy of ePER (within 30%) in first and second morning urine progressively increased from 56% and 71% for low-grade proteinuria (150-299 mg/day) to 60% and 74% for moderate proteinuria (300-999 mg/day), and to 73% and 78% for high-grade proteinuria (≥1000 mg/day). Measures of agreement were similar across histologic phenotypes of allograft injury.Conclusions. The ability of ePER to accurately predict 24-hour proteinuria in kidney transplant recipients is modest. However, accuracy improves with an increase in proteinuria. Given the similar accuracy of ePER measurements in first and second morning urine, second morning urine can be used to monitor protein excretion.

Time-Varying Proteinuria and the Risk of Cardiovascular Disease and Graft Failure in Kidney Transplant Recipients

2021 ◽  
Vol 31 (4) ◽  
pp. 288-297
Author(s):  
Tanya Kuper ◽  
Olusegun Famure ◽  
Jamie Greenfield ◽  
Yanhong Li ◽  
Syed Ibrahim ◽  
...  
Keyword(s):  
Kidney Transplant ◽  
Graft Failure ◽  
Graft Loss ◽  
Major Adverse Cardiac Events ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Cardiac Events ◽  
Urine Protein ◽  
Hazard Ratios ◽  
Adverse Cardiac Events

Introduction: Proteinuria is recognized as an independent risk factor for cardiovascular disease in kidney transplant recipients, but previous studies have not considered the impact of changes in urine protein over time. Research Question and Design: We used time-dependent, multivariable Cox proportional hazards models in this observational cohort study of adult kidney transplant recipients to evaluate whether proteinuria measured by dipstick on random spot urine samples starting from 1-month post-transplant was associated with the risk of major adverse cardiac events and graft loss. Results: A total of 144 major adverse cardiac events, defined as acute myocardial infarction, cerebrovascular accident, revascularization, or all-cause mortality, were observed in 1106 patients over 5728.7 person-years. Any level of proteinuria greater or equal to trace resulted in a two-fold increase in the risk of major adverse cardiac events (hazard ratio 2.00 [95% confidence interval 1.41, 2.84]). This relationship was not found to be dose-dependent (hazard ratios of 2.98, 1.76, 1.63, and 1.54 for trace, 1+, 2+, and 3+ urine protein, respectively). There was an increased risk of graft failure with greater urine protein concentration (hazard ratios 2.22, 2.85, 6.41, and 19.71 for trace, 1+, 2+, and 3+, respectively). Conclusion: Urine protein is associated with major adverse cardiac events and graft loss in kidney transplant recipients. The role of interventions to reduce proteinuria on decreasing the risk of adverse cardiovascular and graft outcomes in kidney transplant recipients requires further study.

scholarly journals Comparative study of 24-hour urinary protein and spot urine protein creatinine ratio in pre-eclamptic women

2021 ◽  
Vol 10 (7) ◽  
pp. 2734
Author(s):  
Rupakala B. M. ◽  
Akshata S. Hiremath
Keyword(s):  
Predictive Value ◽  
Urinary Protein ◽  
Creatinine Ratio ◽  
Spearman Correlation ◽  
Urine Protein ◽  
Spot Urine ◽  
Medical College ◽  
Urine Protein Excretion ◽  
Protein Excretion ◽  
Urine Specimens

Background: The aim of the study was to evaluate the ability of the random urine P/C ratio to predict significant proteinuria, as well as to introduce a diagnostic test for pre-eclampsia which will avoid the inconvenience and time consumption of 24-hour urine protein collection. The objective of this study was to compare spot urine protein- creatinine ratio with 24-hour urine protein for estimation of proteinuria in pre-eclampsia.Methods: A total of 50 pregnant women with pre-eclampsia were prospectively studied for proteinuria in Rajarajeswari medical college and Hospital Bangalore for a period of 9 months from September 2018 to May 2019. Spot urine specimens for measuring P/C ratio were obtained immediately before 24-hour urine collection. The correlation between the spot urine P/C ratio and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test.Results: PCR at a cut off value 0.15 g/mmol had sensitivity and specificity of 96.6% and 55% respectively. In prediction of proteinuria of 300 mg/24 hr positive predictive value and negative predictive value 76.3% and 91.6% respectively.Conclusions: We found that there was a strong correlation between 24-hour urine protein excretion and spot urine protein creatinine ratio in pre-eclamptic women. Spot PCR can be used as a reasonable alternative to 24-hour urine protein test which is a cumbersome.

scholarly journals Assessment of Proteinuria in Nephrotic Syndrome in Children by Using Spot Urinary Protein/Creatinine Ratio

2018 ◽  
Vol 42 (3) ◽  
pp. 108-111
Author(s):  
Delowar Hossain ◽  
Zahiruddin ◽  
Monimul Hoque
Keyword(s):  
Nephrotic Syndrome ◽  
Total Protein ◽  
Mean Value ◽  
Urinary Protein ◽  
Urine Collection ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Spot Urine ◽  
Protein Excretion ◽  
The Mean

Background: Quantification of proteinuria is usually predicted upon 24-hour urine collection. Multiple factors influence urine collection and the rate of protein and creatinine excretion. A spot urine protein-creatinine (P-C) ratio has been shown over the years to be a reliable alternative to the 24-hour collection for detection and follow up of proteinuria. The objective of the study was to evaluate the accuracy of urine protein creatinine ratio (UP/UC) in a spot sample for quantitative measurement of proteinuria in comparison with 24 hours urinary protein excretion in children of nephrotic syndrome having normal Glomerular Filtration Rate (GFR). Methodology: This was a prospective study conducted in the department of paediatrics, Sir Salimullah Medical College & Mitford Hospital Dhaka over a period of six months from January 2003. Fifty cases of Nephrotic syndrome were included who were on initial attack and relapse cases noted down into the proforma with respect to history, examination and investigation. All the patients were advised regarding 24 hours urine collection. They were asked to give a 24 hours urine sample starting at 9.00 am for total protein excretion rate. A spot urine sample was obtained and urine protein/creatinine ratio was calculated. The data was analyzed by linear regression and by calculating the correlation coefficient between urinary protein/ creatinine ratio and 24-hour urinary protein. Results: Sample size was fifty. Urine total protein in a timed 24-hour sample of nephrotic syndrome patients was in the range of 300-3150mg/m2/hour with the mean value of 1725 mg/m2/hour. While as U(Pr/Cr) ratio ranged from 3.1-27.5 with the mean value of 15.2. A significant correlation was found between timed 24-hour urinary protein and UP/UC ratio (r=0.622, p=<.001.) Conclusions: Spot urine protein-creatinine ratio is highly reliable and rapid test for quantification of proteinuria in children with nephrotic syndrome. Bangladesh J Child Health 2018; VOL 42 (3) :108-111

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