Rodby RA, Rohde RD, Sharon Z, Pohl MA, Bain RP, Lewis EJ, for the Collaborative Study Group
The urine protein to creatinine ratio as a predictor of 24-hour urine protein excretion in type 1 diabetic patients with nephropathy

Am J Kidney Dis (Dec) 26:904-909 1995

The protein to creatinine (P/C) ratio measured in a random urine specimen has become a popular substitute for 24-hour protein measurements because it is easier to obtain. However, the utility of this test in clinical practice remains unclear. 229 diabetic patients enrolled in the ACE Inhibition in Type I Diabetic Nephropathy Collaborative Study provided specimens for analysis; 33 patients provided two 24-hr and two random specimens separated by at least a 3-month period. Proteinuria ranged from 0.05 to 13.3 g/d. The log random urine P/C ratio was strongly correlated with log 24 hr urine protein (r=0.90), indicating that the 24 hr value can be predicted from the random specimen. For instance, if it is assumed that the patient is excreting 1.0 g of creatinine daily, a P/C ratio of 0.5 would indicated 0.5 g daily of proteinuria. However, the correlation between P/C ratio and 24 hr values was not as tight when proteinuria was in the nephrotic range. Indeed, among the 33 patients providing two specimens separated in time, the direction in change of the P/C ratio was opposite that of the 24-hr value in almost half of specimens. The authors conclude that although a random P/C ratio is useful in predicting a range of proteinuria in type I diabetic patients, this technique is not recommended for longitudinal patient analysis. (Leehey)

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Proteinuria/Hematuria : Diagnostic approach to proteinuria
Proteinuria/Hematuria : Diabetes