The Spot Urine Protein Creatinine Ratio- Has It Got Real Significance in Staging of Chronic Kidney Diseases?

Abstract

BACKGROUND Proteinuria contributes to progression of chronic kidney disease by several mechanisms. Hence accurate assessment of proteinuria is an essential part of management of chronic kidney disease. In clinical practice, 24 hr urine collection is cumbersome and also error in the collection is seen in 10-20% of samples. So Spot urine protein creatinine ratio could be most suitable and less time-consuming method without compromising quality of assessment of proteinuria. MATERIALS AND METHODS Urine sample of 120 subjects, age between 18 to 70 years with chronic kidney disease was collected. The total 24 hours protein by turbidometric method and the spot urine protein creatinine ratio was taken. The urine creatinine was measured by Jaffe's method. RESULTS In this study, UPCR of stage 3 CKD is 1.9 ± 0.56 gm/ gm of creatinine, stage 4 CKD is of 3.5 ± 0.88 gm/gm of creatinine and that of stage 5 CKD is of 4.1 ± 0.78 gm/gm of creatinine. The 24 hours urine value of CKD stage 1 is 1.1 ± 0.4 gm/ 24 hours, that of stage 2 is 1.6 ± 0.67 gm/24 hours, that of stage 3 is 1.8 ± 0.77 gm/24 hours, that of stage 4 is 3.6 ± 0.58 gm/24 hours and that of stage 5 is 3.9 ± 0.85 gm/ 24 hours. There is significant correlation found between the above values [p value<0.05]. CONCLUSION The UPCR is non-inferior to 24 hours protein estimation in assessing the function of kidney in CKD cases. So UPCR is a simple and cost-effective test in establishing the severity of Chronic kidney diseases and to predict the prognosis.