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Clinical utility of spot urine protein-to-creatinine ratio modified by estimated daily creatinine excretion in children

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Abstract

Background

The spot urine protein-to-creatinine ratio (UPCR) is widely used to predict 24-h urine protein (24-h UP) excretion. In patients with low daily urine creatinine excretion (UCr), however, the UPCR may overestimate 24-h UP. The aim of this study was to predict 24-h UP using UPCR adjusted by estimated 24-h UCr in children.

Methods

This study included 442 children whose 24-h UP and spot UPCR were measured concomitantly. Estimated 24-h UCr was calculated using three previously existing equations. We estimated the 24-h UP excretion from UPCR by multiplying the estimated UCr. The results were compared with the measured 24-h UP.

Results

There was a strong correlation between UPCR and 24-h UP (r = 0.801, P < 0.001), and the correlation improved after multiplying the UPCR by the measured UCr (r = 0.847, P < 0.001). Using the estimated UCr rather than the measured UCr, there was high accuracy and strong correlation between the estimated UPCR weighted by the Cockcroft–Gault equation and 24-h UP. Improvement was also observed in the subgroup (proteinuria vs. non-proteinuria) analysis, particularly in the proteinuria group.

Conclusions

The spot UPCR multiplied by the estimated UCr improved the accuracy of prediction of the 24-h UP in children.

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Acknowledgments

This work was supported by Individual Basic Science & Engineering Research Program through the Ministry of Education of the Republic of Korea and National Research Foundation of Korea (NRF-2016R1D1A1B03933207) and Chonnam National University Hwasun Hospital Institute for Biomedical Science and Basic Science Research Program (HCRI 16916-1)

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Authors and Affiliations

  1. Department of Pediatrics, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Eun Mi Yang, Bo Ae Yoon & Chan Jong Kim

  2. Department of Internal Medicine, Chonnam National University Medical School, 42 Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea

    Soo Wan Kim

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  1. Eun Mi Yang
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  2. Bo Ae Yoon
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  3. Soo Wan Kim
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  4. Chan Jong Kim
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Corresponding author

Correspondence to Chan Jong Kim.

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Ethics statement

The study was approved by the Institutional Review Board (IRB) of Chonnam National University Hospital, Gwangju, Republic of Korea. The study was performed in accordance with the Helsinki Declaration of 1975, as revised in 2000. Each patient in the current study was informed about data usage for this investigation. However, because this study was a retrospective medical record-based study and the study subjects were de-identified, the IRB waived the need for written consent from the patients.

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There are no conflicts of interest.

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Yang, E.M., Yoon, B.A., Kim, S.W. et al. Clinical utility of spot urine protein-to-creatinine ratio modified by estimated daily creatinine excretion in children. Pediatr Nephrol 32, 1045–1051 (2017). https://doi.org/10.1007/s00467-017-3587-6

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  • DOI: https://doi.org/10.1007/s00467-017-3587-6

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