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

Aim and Objective: 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.

Materials and Methods: 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.

Results: UP/C ratio and 24 hour urine protein estimation had strong correlation with r = 0.9 and p < 0.05 on Pearson’s correlation analysis. Receiver operating characteristic analysis showed random UP/C ratio of 0.1171 reliably predicted 24 hour urine total protein equivalent of >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 >3.5 g/24 hrs with sensitivity 80%, specificity 100%, positive likelihood ratio 154.4, and negative likelihood ratio 0.2.

Conclusion: 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.