Assessment of proteinuria by using protein: creatinine index in random urine sample

Abstract

Objective: To assess the quantitative measurement of proteinuria by using random urine protein:creatinine index/ratio in comparison with 24 hours urinary protein excretion in patients of renal diseases having normal glomerular filtration rate.

Methods: One hundred and thirty patients, 94 males and 36 females, with an age range of 5 to 60 years; having proteinuria of more than 150 mg/day were included in this study. Qualitative urinary protein estimation was done on random urine specimen by dipstick. Quantitative measurement of protein in the random and 24 hours urine specimens were carried out by a method based on the formation of a red complex of protein with pyrogallal red in acid medium on Micro lab 200 (Merck). Estimation of creatinine was done on Selectra -2 (Merck) by Jaffe's reaction. The urine protein:creatinine index and ratio were calculated by dividing the urine protein concentration (mg/L) by urine creatinine concentration (mmol/L) multilplied by 10 and mg/mg respectively.

Results: The protein:creatinine index and ratio of more than 140 and 0.18 respectively in a random urine sample indicated pathological proteinuria. An excellent correlation (r=0.96) was found between random urine protein:creatinine index/ratio and standard 24 hours urinary protein excretion in these patients (p<.001). Dipsticks showed moderate correlation (r=0.52) and error in interpretation of proteinuria.

Conclusion: The protein:creatinine index in random urine is a convenient, quick and reliable method of estimation of proteinuria as compared to 24 hours of urinary protein excretion for diagnosis and monitoring of renal diseases in our medical setup.