scholarly journals Spot urinary protein/osmolality ratio as a predictor for proteinuria of nephrotic range

1970 ◽  
Vol 33 (2) ◽  
pp. 65-68
Author(s):  
Salma Jahan ◽  
Md. Saiful Islam ◽  
Md. Moazzam Hossain

A prospective study was carried out on 50 patients (age 1-15 years) with nephrotic range of proteinuria to determine the correlation of 24-hour urinary total protein with spot urinary protein/creatinine ratio and urinary protein/osmolality ratio. Another 50 patients having no proteinuria grouped as control. Twenty-four hours urine and spot urine were collected from each child and were analyzed for total volume, total protein, creatinine and osmolality level. The average 24-hour urinary total proteins in nephritic patient were 2148.6 ± 808.7 mg and the spot urinary protein/creatinine and spot urinary protein/osmolality were 3.2332 ± 0.4293 mg/mg and 3.2418 ± 0.4393 mg/mOsm respectively. There was a strong positive correlation of the 24-hour urinary total protein with spot urinary protein/creatinine and protein/osmolality ratios (r=0.9846 and 0.9870, p= <0.001). But in control group, these ratios did not show any correlation with 24-hour urinary total protein. These results suggest that in pediatric patients with nephrotic range of proteinuria, the spot urinary protein/osmolality ratio can predict the 24-hour  urinary total protein excretion like that of spot urinary protein/creatinine ratios. Keywords: Kidney; Proteinuria; UrinaryDOI: 10.3329/bmrcb.v33i2.1207Bangladesh Med Res Counc Bull 2007; 33: 65-68

2018 ◽  
Vol 42 (3) ◽  
pp. 108-111
Author(s):  
Delowar Hossain ◽  
Zahiruddin ◽  
Monimul Hoque

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


Author(s):  
Indu Kaul ◽  
Bawa Ram Bhagat ◽  
Deepika Sharma ◽  
Gagan Singh

Background: The measurement of albumin: creatinine ratio (ACR) in a spot urine sample avoids the influence of variation in urinary solute concentration and provides a more convenient and rapid method to assess protein excretion. The aim of this study was to evaluate urinary spot ACR as a new marker for proteinuria and to study its correlation and accuracy in comparison with 24-hour urinary protein.Methods: The prospective one-year study was conducted on 100 pregnant women, 18-40 years, >20 weeks gestation with a diagnosis of preeclampsia. A spot midstream urine sample was taken for detection of albuminuria by dipstick method. Another spot sample was taken for detection and calculation of spot ACR. The 24-hour urine collection was taken immediately afterward to evaluate 24-hour urinary protein excretion.Results: A positive linear relation exists between ACR and 24-hour urinary protein excretion The ROC revealed cut-off of 20.4 with 88.5% sensitivity, 75% specificity, 98.8% positive predictive value and 21.4% negative predictive value. Spot urinary ACR >20.4 correctly identified women having 24-hour urinary protein excretion in excess of 0.3 gm/DL.Conclusions: A strong correlation exists between single spot urinary ACR with 24-hour urinary protein excretion in women with preeclampsia.


Author(s):  
Rupakala B. M. ◽  
Akshata S. Hiremath

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.


2010 ◽  
Vol 138 (11-12) ◽  
pp. 726-731
Author(s):  
Visnja Lezaic ◽  
Stojanka Ristic ◽  
Violeta Dopsaj ◽  
Jelena Marinkovic

Introduction. Proteinuria is the most frequent marker of kidney damage. Although 24-hour urinary proteinuria is the gold standard, the measurement of proteinuria from albumin urinary creatinine ratio is proposed as much useful metod. Objective. To evaluate the accuracy of urine protein-to-creatinine (P/Cr) ratio in morning urine specimens as compared with 24-hour total protein excretion for the measurement of proteinuria in patients with different kidney diseases and different renal function levels. Methods. Proteinuria in the studied patients was assessed by 24-hour protein excretion (24-hour PRT) and spot urine P/Cr ratio. The analysis of concordance between 24-hour PRT and P/ Cr was carried out using intraclass correlation coefficient (ICC), paired t-test and Bland-Altman plots. The discriminant cutoff values for spot urine P/Cr ratio in predicting 24-hour protein ?threshold? excretion were determined using receiver operating characteristic curves (ROC), as well as sensitivity and specificity. Results. A total of 303 patients were included in the study. The concordance between 24-hour PRT and P/Cr ratio was excellent (ICC 0.931). Systematic overestimation of PRT by urinary P/ Cr ratio was disclosed (mean difference 0.138, p=0.011). The P/ Cr of 0.25 (sensitivity 0.90; specificity 0.96), 0.66 (1.00; 0.91) and 2.55 (1.0; 0.97) g/g reliably predicted 24-hour urine total protein equivalent ?thresholds? at 0.2, 1.0 and 3.5 g/day. The chronic renal failure group independently positively influenced the difference between 24-hour PRT and P/Cr. It means the lower the kidney function the higher is the difference between the two proteinuria measurements. Conclusion. This study supports the recommendation of using spot urine P/Cr ratio in proteinuria screening in patients with different kidney diseases. The obtained results indicated better agreement between morning P/Cr and 24-hour PRT in patients with lower proteinuria and better kidney function.


Author(s):  
Vikas Yadav ◽  
Dipika Deka ◽  
Aparna Sharma ◽  
Vatsla Dadhwal

Background: Maternal RBC alloimmunization results from exposure and response to a foreign RBC antigen. Transplacental fetal to maternal hemorrhage is the most common cause of alloimmunization. Rh incompatibility can lead to either fetuses with hydropic features or non-hydropic. The precise mechanism leading to the development of hydrops is uncertain. Biochemical markers have the potential to be used to assess the severity of problem. But of the mechanisms proposed none have been able to totally explain the phenomenon or predict the prognosis. Objective of this study wads to compare the difference in mean total protein, albumin and globulin bases on severity of isoimmunization and comparing it with normal controls.Methods: A Total of 40 pregnant patients were enrolled which included 10 hydropic fetuses of Rh isoimmunised mothers, 10 non hydropic fetuses of Rh isoimmunized mothers. Control group included 18 Rh positive women without any fetal complication and 2 fetuses in women undergoing cordocentesis. Blood sampling was done at time of intrauterine transfusion and sent for estimation of total proteins, albumin, globulin in fetal blood. Pregnancies were followed up till delivery and fetal outcome noted.Results: Mean total protein, albumin and globulin between hydropic, non hydropic group and control group (3.25, 2.17 and 1.18 g/dl) in hydropic, (4.14, 2.70 and 1.44 g/dl) in non hydropic and (4.42, 2.95 and 1.47 g/dl) in control group respectively. Mean total protein, albumin and globulin between mild hydropic (3.43, 2.30 and 2.10 g/dl) and severe hydropic group (2.59, 1.6 and 1.3 g/dl) respectively.Conclusions: There was significantly lower levels of serum total proteins, albumin and globulin in hydropic fetuses as compared to non hydropic fetuses. Thus, hypoproteinemia can be considered a strong marker for development of hydrops in Rh isoimmunized fetuses.


2019 ◽  
Vol 14 (2) ◽  
pp. 49-53
Author(s):  
Nesuma Sedhain ◽  
Jageshwor Gautam ◽  
Gehanath Baral

Aim: To assess the diagnostic accuracy of spot urine protein-creatinine ratio for detection of proteinuria in Preeclampsia. Methods: Cross Sectional Descriptive Study was conducted in a total of 38 pregnant women in Paropakar Maternity and Women’s Hospital in study period of 3 month. The correlation between protein- creatinine ratio in spot urine samples and urinary protein excretion in 24-hour collections were analyzed. Results: Comparison of 24 hours urinary protein and protein- creatinine ratio in women with preeclampsia shows a significant correlation (r=0.911, p<0.0001). The cut-off protein-creatinine ratios which gave maximum area under the curve for 300mg protein for 24hrs was 0.27 (sensitivity: 94.6%, specificity: 100%, PPV: 100%, NPV: 33.3%); 2000 mg urine protein excretion was 2.1 (sensitivity and specificity of 100%); 3000mg protein excreted for 24hours was 3.0 (sensitivity: 83.3%, specificity: 92.3%, PPV: 83.3%, NPV: 93.3%. Area under the ROC for 24hours urine total protein of >300mg, >2000mg and >3000mg/day were 0.946 (95%CI 0.873-1.019), 1 (95% CI 1.00-1.00) and 0.957 (95%CI 0.897- 1.016) respectively. Conclusions: Spot urine protein-creatinine ratio is as accurate as to 24 hours urine protein determination of proteinuria in Preeclampsia.


2021 ◽  
pp. 53-54
Author(s):  
B Revanth Reddy ◽  
Gauri Chauhan ◽  
Anand Kumar Bhardwaj ◽  
Sasanka Chakrabarti

Introduction: Perinatal asphyxia is one of the leading causes of perinatal morbidity and mortality. Feasible and early biochemical markers to diagnose and predict the neurologic outcome is a great need of time as APGAR score alone is inuenced by various factors. The present study was performed to determine the urinary uric acid to creatinine ratio in perinatal asphyxia and its correlation with APGAR score and compare urinary uric acid to creatinine ratio with Sarnat and Sarnat staging. Materials and Methods: This study was carried out on 100 term neonates with an equal number of cases and control 50 each, control group being the neonates with Apgar score ≥ 7 at 1 minute of life and cases being the neonates who suffered from perinatal asphyxia with Apgar < 7 at 1 minute of life. The spot urine sample was collected within 24 hours of birth and their uric acid and creatinine levels were measured and the ratio calculated. Asphyxiated neonates were classied according to Sarnat and Sarnat staging. We Compare UA/Cr ratio with Apgar score and HIE staging using Sarnat and Sarnat staging.Results: On comparison of UUA/Cr among cases and controls we found that ratio was signicantly higher in asphyxiated neonates as compared to non asphyxiate neonates. (Control vs. Cases Group: 2.4 ± 1 vs. 3.6 ± 1.5; p –value < 0.0001). On comparison of UUA/Cr among cases with Sarnat and Sarnat staging of HIE, there is a signicant difference observed in mean UA/Cr ratio across Sarnat and Sarnat staging of HIE (F – Value = 68.760; p – value = 0.0001). Conclusion: Urinary uric acid and creatinine ratio can be used as markers for perinatal asphyxia for screening in centers where other markers for assessing perinatal asphyxia are not available. Urinary uric acid and creatinine ratio is a non-invasive, cheap and easily available marker for assessing the severity perinatal asphyxia.


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