Controversies in NephrologyTimed Urine Collections Are Not Needed to Measure Urine Protein Excretion in Clinical Practice
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P/C Ratio in Nondiabetic and Diabetic Glomerulopathies
During the last 2 decades, several studies suggested that determination of P/C ratio in single random urine specimens can be used as a surrogate for 24-hour urine protein excretion.12, 13, 14 This is based on the observation that when protein and creatinine concentrations for the P/C ratio are given in comparable units (usually milligrams per deciliter), P/C ratio shows a linear correlation with 24-hour urine protein excretion (in grams per day). On this basis, the Work Group of the Kidney
P/C Ratio in Pregnancy
Proteinuria is a major indicator of preeclampsia and also one of the diagnostic criteria of its severity.30 The gold standard for the diagnosis of significant proteinuria is 24-hour urine collection in women with hypertensive disorders of pregnancy. However, also for pregnant women, a quicker and easier method to evaluate the quantity of urinary protein without compromising accuracy would be appealing. Studies have documented good correlation between random urine P/C ratio and 24-hour total
Albumin-Creatinine Ratio in Patients With Diabetes
In patients with type 1 and type 2 diabetes mellitus, the presence of urinary albumin excretion of 30 mg/d or greater is highly predictive of the later occurrence of overt nephropathy and cardiovascular events.37, 38, 39, 40 Thus, yearly measurement of urinary albumin excretion rates is considered a component of the standards of care for patients with diabetes.41 The method for this measurement requires collection of 24-hour or overnight timed urine specimens.37, 42, 43 Other data suggested
Spot Urinary P/C Ratio and Renal Disease Progression
In addition to its relationship with 24-hour proteinuria, the ultimate clinical meaning of random P/C ratio would be its capability to predict progression to end-stage renal failure in routine clinical practice. This was addressed by a cross-sectional longitudinal study of 177 patients with nondiabetic chronic renal disease and persistent clinical proteinuria, screened for evaluation of their eligibility to assess the efficacy of an angiotensin-converting enzyme inhibitor in the treatment of
Conclusion
P/C ratio in spot urine samples is a reasonably precise indicator of 24-hour proteinuria and a reliable predictor of progression of disease in patients with chronic nephropathies. Good correlation and agreement between the 2 methods are shown across the entire range of proteinuria in patients with glomerular diseases of diverse causes and at different levels of renal function. Random urinary P/C ratio could predict 24-hour urine protein estimation, particularly at a lower level of proteinuria,
References (47)
- et al.
Albuminuria as early test for vascular disease
Lancet
(2005) - et al.
Chronic kidney disease and cardiovascular disease in the Medicare population
Kidney Int Suppl
(2003) - et al.
The role of proteinuria in the progression of chronic renal failure
Am J Kidney Dis
(1996) - et al.
Urinary protein excretion rate is the best independent predictor of ESRF in non-diabetic proteinuric chronic nephropathies. “Gruppo Italiano di Studi Epidemiologici in Nefrologia” (GISEN)
Kidney Int
(1998) - et al.
The urine protein to creatinine ratio as a predictor of 24-hour urine protein excretion in type 1 diabetic patients with nephropathy
Am J Kidney Dis
(1995) - et al.
Quantitation of proteinuria with urinary protein/creatinine ratios and random testing with dipsticks in nephrotic children
J Pediatr
(1990) - et al.
Random protein-creatinine ratio for the quantitation of proteinuria in pregnancy
Obstet Gynecol
(1997) - et al.
Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy
Am J Obstet Gynecol
(2001) - et al.
Protein/creatinine ratio in the assessment of proteinuria during pregnancy
Eur J Obstet Gynecol Reprod Biol
(1988) - et al.
Prediction of 24-hour protein excretion in pregnancy with a single voided urine protein-to-creatinine ratio
Am J Obstet Gynecol
(2002)
A prospective comparison of total protein/creatinine ratio versus 24-hour urine protein in women with suspected preeclampsia
Am J Obstet Gynecol
Microalbuminuria as a predictor of clinical nephropathy in insulin-dependent diabetes mellitus
Lancet
The validity of screening based on spot morning urine samples to detect subjects with microalbuminuria in the general population
Kidney Int Suppl
Forecast of the number of patients with end-stage renal disease in the United States to the year 2010
J Am Soc Nephrol
Maintenance dialysis population dynamicsCurrent trends and long-term implications
J Am Soc Nephrol
Pathophysiology of progressive nephropathies
N Engl J Med
Proteinuria and interstitial injury
Nephrol Dial Transplant
Laboratory evaluation of renal function
Protein creatinine index and Albustix in assessment of proteinuria
Br Med J
Is morning urinary protein/creatinine ratio a reliable estimator of 24-hour proteinuria in patients with glomerulonephritis and different levels of renal function?
J Nephrol
Use of single voided urine samples to estimate quantitative proteinuria
N Engl J Med
Proteinuria in health and disease assessed by measuring the urinary protein/creatinine ratio
Clin Chem
Quantitation of proteinuria by the use of protein-to-creatinine ratios in single urine samples
Arch Intern Med
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Evaluation of proteinuria redux
2016, Kidney InternationalComparison of associations of urine protein-creatinine ratio versus albumin-creatinine ratio with complications of CKD: A cross-sectional analysis
2013, American Journal of Kidney DiseasesCitation Excerpt :The 2 predictors were spot urine PCR and spot urine ACR. Because spot sample ratios have been shown to correlate well with 24-hour urine collection measurements, ACR and PCR are commonly measured in clinical practice for convenience.25-27 PCR (mg/g) was calculated as spot urine total protein concentration divided by spot urine creatinine concentration, and ACR (mg/g) was calculated as spot urine albumin concentration divided by spot urine creatinine concentration from 24-hour urine samples.
Shorter bevacizumab infusions do not increase the incidence of proteinuria and hypertension
2013, Annals of OncologyCitation Excerpt :The secondary end point of the study was incidence of hypertension. The grading of proteinuria and hypertension is provided in Table 1. [15–19] A modified grading criterion was utilized for hypertension assessment due to the observational nature of the study design.
Mass Spectrometric Analysis of Urinary N-Glycosylation Changes in Patients with Parkinson’s Disease
2023, ACS Chemical Neuroscience
Originally published online as doi:10.1053/j.ajkd.2005.10.014 on December 6, 2005.