Protein and Albumin to Creatinine Ratio and their Loss in Urine Associated with Kidney Diseases.
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Date
2011
Authors
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Publisher
Addis Abeba University
Abstract
Abstract
Background: Proteinuria is recognized as an independent risk factor for cardiovascular and renal
disease and as a predictor of end organ damage. Appearance of albumin in the urine is one of the
first sign of deteriorated kidney function. As the kidney functions decreases, the amount of
albumin in the urine increases. So, Albumin: Creatinine ratio and/or Protein: Creatinine ratio on
random urine sample provides significant results for quantitating proteinuria against
conventional 24-hours sample collection.
Objective: - To review and recommend the method(s) for quantitating proteinuria using urinary
Albumin: Creatinine ratio and/or Protein: Creatinine ratio on random urine samples vis-a-vis
conventional 24-hours urine collection for diagnostic evaluation of Kidney function.
Methods: I performed a systematic review of literatures on measurement of Albumin: Creatinine
ratio and/or Protein: Creatinine ratio on a random urine compared with the conventional 24hours
urine
collection
method.
Results: Data were extracted from 8 studies which investigating proteinuria in several settings.
Patient groups in the studied were primarily those with hypertension, diabetic, preeclampsia or
renal disease. Urine Microalbumin: Creatinine ratio, Albumin: Creatinine ratio and Protein:
Creatinine ratio vs. 24-hours urine specimen has correlation coefficients (r>0.84, p<0.001)
except urinary Microalbumin: Creatinine ratio (r ≈ 0.743) and Sensitivities, specificities for the
tests were 83% (ranged 66% to 100%) and 76.5% (ranged 53% to 100%), respectively, whereas
positive and negative predictive values were 80.5% (ranged 61% to 100%) and 87.5% (ranged
75% to 100%), respectively.
Conclusion: The use of Albumin: Creatinine ratio and/or Protein: Creatinine on a random urine
specimen provides significant correlation with conventional method of a 24-hours urine
specimen collection. The analysis of the report reviewed has also revealed that, total Protein:
Creatinine ratio has better sensitivity as compared to Albumin: Creatinine ratio in quantitating
proteinuria.
Description
Keywords
urinary spot microalbumin: Creatinine ratio (MACR)”, “spot albumin-creatinine ratio (ACR)”, “spot protein-creatinine ratio (PCR)” and/or spot “total Protein: Creatinine ratio (TPCR)” vs. “24-hours urine sample collection