Estimation of Proteinuria in Type 2 Diabetes Mellitus: Is Spot Urine Protein-Creatinine Ratio as Efficacious as 24 Hours Urinary Protein?
International Journal of Contemporary Medical Research [IJCMR]
Diabetic nephropathy is a leading cause of morbidity and mortality in patients with diabetes mellitus. This study aims to compare the efficacy of spot urine protein creatinine ratio (PCR) with 24 hours urinary protein and urinary dipstick analysis in detection of proteinuria in patients with type 2 diabetes mellitus. Material and methods: Cross sectional study involving 75 consecutive patients with type 2 diabetes mellitus. The relationship between spot urine PCR and 24 urine protein and the
... protein and the relationship between spot urine PCR and urine protein dipstick analysis was found out using Pearson's correlation analysis. The sensitivity, specificity, positive predictive value, negative predictive value of spot urine PCR for detecting proteinuria at a cut off value of 0.2 was calculated. Results: 75 patients of type 2 Diabetes mellitus were included (56 males and 19 females). The mean spot PCR was 0.38+/-0.57 and the mean 24 hour urinary protein was 84.85+/-43.54 mg/day. Good positive correlation between spot urine PCR and 24 hour urine protein (r= 0.805) was noted. The sensitivity of spot urine PCR at a cutoff value of 0.2 was 98.25% and specificity was 94.44%. The area under curve for urine PCR was 0.996 (95% Confidence interval:0.986-1, p<0.0001). Conclusion: The spot urine PCR is as reliable as 24 hour urine protein and more reliable than spot urine dipstick analysis in detecting proteinuria in patients with type 2 diabetes mellitus. Hence, spot urine PCR can be used as an alternative to 24 hour urine protein for estimating proteinuria.