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Urine protein/creatinine ratio is a widely used initial method to estimate daily protein excretion in urine. [1] [2] [3] Since the diagnosis and management of proteinuric renal diseases and the staging of chronic kidney disease depend on accurate identification and quantitation of proteinuria, [4] [1] the implementation of the 24-hour urine collection is the most accurate procedure in practice ...
Abnormal kidney function may cause too much or too little urine to be produced. The ability of the kidneys to filter protein is often measured, as urine albumin or urine protein levels, [2] measured either at a single instance or, because of variation throughout the day, as 24-hour urine tests. [citation needed]
An expected creatinine concentration indicates that the test sample is undiluted, whereas low amounts of creatinine in the urine indicate either a manipulated test or low initial baseline creatinine concentrations. Test samples considered manipulated due to low creatinine are not tested, and the test is sometimes considered failed.
Injury: Two-fold increase in the serum creatinine, or GFR decrease by 50 percent, or urine output <0.5 mL/kg per hour for 12 hours. Failure: Three-fold increase in the serum creatinine, or GFR decrease by 75 percent, or urine output of <0.3 mL/kg per hour for 24 hours, or no urine output (anuria) for 12 hours.
The picture of acute kidney failure is observed: decreased urine production and rapidly rising serum creatinine levels. Acute uric acid nephropathy is differentiated from other forms of acute kidney failure by the finding of a urine uric acid/creatinine ratio > 1 in a random urine sample.
Alternatively, the concentration of protein in the urine may be compared to the creatinine level in a spot urine sample. This is termed the protein/creatinine ratio. The 2005 UK Chronic Kidney Disease guidelines state that protein/creatinine ratio is a better test than 24-hour urinary protein measurement.
Urinary albumin excretion can also be measured by urinary albumin/creatinine ratio in a spot urine sample, which is as accurate but more convenient than a 24-hour urine collection. [ 29 ] It is recommended that individuals with diabetes have their albumin levels checked annually, beginning immediately after a diagnosis of type 2 diabetes and ...
Trace levels of protein in the urine can be normal, [60] but high levels (proteinuria) can indicate kidney disease. [45] Most cases of proteinuria are caused by increased levels of albumin , [ 61 ] which test strips can detect relatively well; but they are markedly less sensitive to other proteins, such as Bence-Jones protein , [ 62 ] which may ...