Published: 2016-12-16

Evaluation of protein: creatinine ratio on random urine samples in assessment of proteinuria

Vyankatesh T. Anchinmane, Shilpa V. Sankhe


Background: Significant proteinuria (>300mg/day) may indicate the presence of important renal disease. Quantitative estimation of urinary protein over 24 hours is the gold standard test for detection of proteinuria. However, 24 hours urine collection method is inconvenient and cumbersome to patients. The present study was undertaken to determine diagnostic accuracy of random urine protein: creatinine ratio for the diagnosis of proteinuria among patients with renal diseases.

Methods: The prospective study was done in 200 nephropathy cases. The 24 hours urinary protein test used as gold standard test and compared with their random urine sample protein: creatinine ratio (cut off >0.3). The data analyzed for sensitivity, specificity and accuracy of random urine sample protein: creatinine ratio test.

Results: Random urine sample protein: creatinine ratio test showed sensitivity, specificity and accuracy of 95.6%, 94.4% and 95.5% respectively

Conclusions: The convenient and accurate protein: creatinine ratio method on random urine samples is reliable method for estimation and screening the proteinuria cases over quantification of proteinuria by collection of 24 hours urine samples and hence, a wider application of this method is recommended.


Proteinuria, Protein:creatinine ratio

Full Text:



Price CP, Newall RG, Boyd JC. Use of protein: creatinine ratio measurements on random urine samples for prediction of significant proteinuria: a systematic review. Clinical Chemistry. 2005;51(9):1577-86.

Jayasekara JMKB, Dissanayake DM, Gunaratne MDN, Amunugama K. Estimation of 24 hour protein in CKD patients by analyzing the protein/creatinine ratio of four spot urine samples. Inter J Scie Res Pub. 2013;3(3):1-5.

Shaw AB, Risdon P, Lewis-Jackson JD. Protein Creatinine Index And Albustix In Assessment Of Proteinuria. British Med J. 1983;287(6397):929-32.

Pariyaeksut P, Lertbunnaphong T, Leetheeragul J, Boriboonhirunsarn D. A correlation between first-void morning urinary protein to creatinine ratio (UPCR) and 24 hours urinary protein in pregnancy with suspected preeclampsia. Thai Journal of Obstetrics and Gynaecology. 2014;22:173-80.

Papanna R, Mann LK, Kouides RW, Glantz JC. Protein/ Creatinine ratio in preeclampsia: a systematic review. Obstet Gynecol. 2008;112(1):135-44.

Fulks M, Stout RL, Dolan VF. Urine Protein/Creatinine Ratio as a Mortality Risk Predictor in Non-Diabetics with Normal Renal Function. J Insur Med. 2012;43(2):76-83.

Shahbazian N, Farjanet HF. A comparison of spot urine protein-creatinine ratio with 24-hours urine protein excretion in women with pre-eclampsia. Iranian Journal of Kidney Diseases. 2008;2:127-31.

Lea-os-Miranda A, Márquez-Acosta J, Romero-Arauz F, Cárdenas-Mondragón GM, Rivera-Lea-os R, Isordia-Salas I, et al. Protein: creatinine ratio in random urine samples is a reliable marker of increased 24-hour protein excretion in hospitalized women with hypertensive disorders of pregnancy. Clin Chem. 2007;53:1623-8.

Eslamian L, Behnam F, Tehrani ZF, Jamal A, Marsoosi V. Random urine protein creatinine ratio as a preadmission test in hypertensive pregnancies with urinary protein creatinine ratio. Acta Medica Iranica. 2011;49:81-4.

Sharma A, Kiran P, Ajaj B. Spot urine protein/creatinine ratio-A quick and accurate method for diagnosis of preeclampsia. OJOG. 2013;3:609-12.