The urine protein to creatinine ratio (P/C) as a predictor of 24-hour urine protein excretion in renal transplant patients.

Abstract:

BACKGROUND:The purpose of this study was to examine the utility of the random urine protein to creatinine ratio (P/C) in evaluation and longitudinal management of proteinuria in adult renal transplant recipients with or without overt nephropathy in an outpatient clinic. METHODS:A total of 289 adult renal transplant recipients provided 24-hr urine collections for total protein and creatinine, followed by a random urine for protein and creatinine. For longitudinal analysis, 192 of these patients provided two 24-hr urine collections with concomitant random urine specimens separated on average by 6.8 months. As well, 134 patients provided a total of 851 multiple-paired spot and 24-hr urine samples (range 2 to 12) over a 2-year period. RESULTS:The log random urine P/C ratio correlated significantly to the log 24 UP (r=0.749, P<0.0001) with or without nephrotic range proteinuria. High sensitivity (74.4-90%) and specificity values (93-98%) were found for estimating proteinuria from 0.5 to 2 g/day. However, the precision of estimation decreased as the level of urinary protein excretion increased to >3 g/day. The positive predictive value decreased as proteinuria became >3 g/day, perhaps because of the low prevalence of patients with high level proteinuria in our sample. The direction of change in P/C ratio longitudinally was accompanied by a similar direction of change in 24 UP, which was highly significant (r=0.7555, P<0.0001). CONCLUSION:We conclude that the urine P/C ratio is a useful and convenient screening and longitudinal test for proteinuria.

journal_name

Transplantation

journal_title

Transplantation

authors

Torng S,Rigatto C,Rush DN,Nickerson P,Jeffery JR

doi

10.1097/00007890-200110270-00021

subject

Has Abstract

pub_date

2001-10-27 00:00:00

pages

1453-6

issue

8

eissn

0041-1337

issn

1534-6080

journal_volume

72

pub_type

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