134 Vol. 6 No. 3, July-September 2004 JK SCIENCE Evaluation of Random Urine Sample Protein-Cretinine Ratio as an Index of Quantitative Proteinuria Sandeep Garg, Alok Kumar Gupta*, Anurag Rohtgi, SK Sharma From Deptt. of Medicine Lady Hardinge Medical College & Smt. Sucheta Kriuplani Hospial & *Appolo Hospital New Delhi. Correspondece to: Dr. Sandeep Garg, B-403, Street No.4, Majlis Park, Near Adarsh Nagar, Delhi-110033 ORIGINALARTICLE Introduction Proteinuria is one of the earliest sign of almost all renal diseases (1). Proteinuria occurs due to damage to glomerular apparatus (glomerular proteinuria) or due to failure of reabsorbtion of the filtered protein by tubular cells (tubular proteinuria). Normally most healthy adults excrete between 20-150 mg of protein in urine over 24 hrs and proteinuria >3.5 gm/day is taken to be diagnostic of nephrotic syndrome (2). Estimation of proteinuria helps in differentiating between tubulointerstital and glomerular diseases, to follow the progress of renal disease and to assess the response to therapy (3). Quantitating protein in urine is thus a cornerstone in diagnosis, treatment and prognosis of renal diseases.The most common method relies on estimation of 24hrs UP in a urine specimen collected over 24hrs. However, 24hr UP estmation method has certain pitfalls and thus leads to discarding of nearly 1/3rd of the samples (4). To obviate these difficulities short timed urine collection have been advocated with the hypothesis that protein excretion is nearly constant throughout the day and various studies, have estimated protenuria by taking urine samples at 2 hrs, 3 hrs and 4 hrs (5, 6). These studies however were not validated. Because of problems with timed urine collection, 24 hr. UP excretion using single timed voided sample has been estimated. It has been reported that in the presence of stable GFR (glomerular filtration rate) urinary creatinine excretion is fairly constant in a given individual, the fact serving as principle behind the use of Abstract The present study was conducted to find out a correlation between protein to creatinine (PC) ratio in random sample and 24 hr. urinary protein (UP) in patients with proteinuria with normal renal functions (serum cretinine<1.5 mg %) -group-I, with impaired renal functions, mild to moderate (s.cretinine 1.5-4.0mg%) group-II and advance renal failure (s.cretinine >4.0mg%) -group-III. 24 hr. and a random urine sample was taken for each patient and was tested for protein and creatinine. PC ratio was found in each random sample. The mean 24 hr.UP (g/24 hr.) estimated by 24 hr. urine collection was 1.15± 0.97, 3.26 ±1.34 and 7.39±2.19 in group I, II and III respectively. However, the mean UP estimated by random sample was 1.35±1.09, 3.94±1.93 and 10.38±3.70 in group-1, group-II and group-III respectively. P value was statistically insignificant in group 1 & II. However, there was significant difference in values in group-III (P=0.012). Coefficient of correlation on univariate analysis was r=0.889 in group-I, 0.788 in group-II and 0.375 in group-III indicating a significant correlation in results in groupI and II and not in group-III. The results in the study have shown that single voided urine method of estimating quantitative proteinuria holds its value in patients with normal, as well as in mild to moderately impaired renal functions. However, this method does not hold good for patients with severely impaired renal functions. Key Words Proteinuria, Protein to creatinine ratio