Department of Nephrology, Gr. Vosnides, Laiko General Hospital, Athens, Greece.
Ren Fail. 2010 Jan;32(2):153-6. doi: 10.3109/08860220903491208.
The aim of this study was to evaluate the severity of proteinuria using the protein/creatinine ratio in a random urine sample. In 45 patients (male 28, female 17; mean age 50.68 +/- 18.26 years) with proteinuria of various causes, we measured the 24-hour protein excretion per 1.73 m(2) of body surface and, during the same day, the protein/creatinine ratio in three different urine samples (8 am, 12 pm, 4 pm). The 24 h proteinuria was defined as mild (<1 g), moderate (1-3.4 g), and severe (>3.4 g) in 7, 27, and 11 patients, respectively. The sensitivity for protein/creatinine ratio compared to the 24 h proteinuria as a method of reference was 86-100% in the mild, 78-100% in the moderate, and 73-82% in the severe proteinuria, whereas the specificity was 84-100%, 78-83%, and 100% respectively. The patients with better renal function had significantly higher proteinuria levels. There was a similarity in the 24 h proteinuria and the protein/creatinine ratio measurements in all renal function and level-of-proteinuria groups. The protein/creatinine ratio of the morning and midday samples had a very good association with the 24 h sample, whereas it was not associated significantly with the evening sample (4 pm). In conclusion, the degree of 24 h proteinuria levels can be evaluated by calculating the protein/creatinine ratio in a random urine sample collected at any time from morning until midday. Protein/creatinine ratio is independent of the severity of proteinuria or renal function, and it can replace in clinical practice the cumbersome 24 h urine collections.
本研究旨在通过测定随机尿样中的蛋白/肌酐比值评估蛋白尿的严重程度。在 45 例（男 28 例，女 17 例；平均年龄 50.68 +/- 18.26 岁）不同病因的蛋白尿患者中，我们测量了 1.73 平方米体表面积 24 小时的蛋白排泄量，并在同一天测量了 3 个不同尿样（8 点、12 点、4 点）的蛋白/肌酐比值。24 小时蛋白尿定义为轻度（<1 g）、中度（1-3.4 g）和重度（>3.4 g），分别有 7、27 和 11 例患者。与 24 小时蛋白尿相比，蛋白/肌酐比值作为参考方法的敏感性在轻度蛋白尿中为 86-100%，在中度蛋白尿中为 78-100%，在重度蛋白尿中为 73-82%，特异性分别为 84-100%、78-83%和 100%。肾功能较好的患者蛋白尿水平明显较高。在所有肾功能和蛋白尿水平组中，24 小时蛋白尿和蛋白/肌酐比值的测量值相似。早晨和中午样本的蛋白/肌酐比值与 24 小时样本有很好的相关性，而与晚上样本（4 点）无显著相关性。结论：可通过计算任何时间（从早晨到中午）采集的随机尿样中的蛋白/肌酐比值评估 24 小时蛋白尿水平的严重程度。蛋白/肌酐比值与蛋白尿严重程度或肾功能无关，可替代临床实践中的繁琐 24 小时尿收集。
