Spot idrarda protein/kreatinin ve albumin/kreatinin orani ile 24 saatlik idrarda total protein ve albumin miktarinin korelasyonu

Correlation Between the Ratios of Protein/Creatinine and Albumin/Creatinine in the Spotting Urine; and the Levels of Protein and Albumin in the 24 Hours Collected UrineBackground and Aims: Proteinuria is an independent risk factor for renal and cardiovascular diseases and a predictor of end organ damage. The reference test for proteinuria is measurement of the level of protein and albumin in the urine for 24 hours. However collecting urine for 24 hours is usually difficult for the patients and may lead to incorrect results. Therefore it is preferred to the ratios of protein/creatinine and albumin/creatinine in spotting urine instead of measuring the level of proteinuria and albumin for 24 hours in urine. We studied the reliability and convenience of equality of 24 hours albumin and protein levels in urine and the protein/creatinine ratio and albumin/creatinine ratio from a spotting urine in diabetes mellitus, hypertension, chronic kidney disease and nephrotic syndrome patients at Cukurova University Internal Medicine outpatients.Materials and Methods: The study included 130 patients (female:57 male:73, mean age:53,5±15,4) who admitted to Cukurova University Medical Faculty Hospital. An extensive history was provided and physical examination was performed. Blood pressure and glomerular filtration rates were measured, the drugs used were questioned. These patients were asked for to collect 24 hours urine and morning spotting urine in addition to other routine procedures. The levels of albumin, creatinine, protein in spotting urine and levels of albumin, creatinine protein in the urine for 24 hours were measured. The ratios of albumin/creatinine and protein/creatinine in the spotting urine were calculated. The ratios of albumin/creatinine and protein/creatinine in the spotting urine and the levels of protein and albumin in 24 hours urine were compared. The correlation between spotting morning urine calculated (albumin/creatinine and protein/creatinine) levels and 24 hours urine albumin and protein levels was assessed. In addition age, gender, body mass index, presence of hypertension, presence of kidney disease, and albumin level in the serum were used to create a model with regression analyses to evaluate the nearest measured values.Results: We have seen that the ratios of albumin/creatinine and protein/creatinine in the spotting urine were as reliable as the data obtained from the 24 hours urine. The ratios of albumin/creatinine and protein/creatinine in the spotting urine were very similar to the ratios of albumin/creatinine and protein/creatinine in the 24 hour urine, and the obtained data can be used instead of each other. The correlation between ratio of protein/creatinine in spotting urine and urine protein of 24 hours was 86 %. The correlation between ratio of albumin/creatinine in spotting urine and urine protein of 24 hours was 92 %. In our hospital significant albumin/creatinine ratio has been accepted as 0,372 and higher values in spotting urine sample sensitivity were 95 % and specificity 95 %. Significant protein/creatinine ratio has been accepted as 0,480 and higher values in spotting urine sample sensitivity were 88 % and specificity 96 %. R value was 92 % in the patients with 3000 mg proteinuria and higher protein values with regression analysis. R value was 87 % in the patients with 300 mg albuminuria and higher albumin values with regression analysis. It was suggested that the regression model were more reliable for the patients with 24 hours urine protein lower than 3000 mg and 24 hours urine albumin lower than 300 mg.In Conclusion: In our study, we suggested that measurements of the ratios of albumin/creatinine and protein/creatinine in spotting urine could be usable method for establishing the values of protein and albumin in the 24 hours urine but for the 24 hours proteinuria lower than 3000 mg and albuminuria lower than 300 mg using regression model was found more close to referance values.Key Words: Urine albumin to creatinine ratio, urine protein to creatinine ratio, microalbuminuria, proteinuria