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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 ...
Example of a container used for collecting 24-hour urine samples. This particular container is free of trace metals to allow for accurate measurement of these substances in urine. The techniques used to collect urine specimens vary based on the desired test. A random urine, meaning a specimen that is collected at any time, can be used for many ...
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]
If proteinuria is persistently detected by dipstick testing, a 24-hour urine collection can be performed to obtain an accurate measurement of protein levels; alternatively, protein excretion can be estimated from the urine protein/creatinine ratio of a single specimen. Measuring the amount of protein in the urine helps to distinguish between ...
A better estimate of kidney function is given by calculating the estimated glomerular filtration rate (eGFR). eGFR can be calculated without a 24-hour urine collection, using serum creatinine concentration and some or all of the following variables: sex, age, and weight, as suggested by the American Diabetes Association. [19]
To assess the adequacy of a complete collection, one always calculates the amount of creatinine excreted over a 24-hour period. This amount varies with muscle mass and is higher in young people/old, and in men/women. An unexpectedly low or high 24-hour creatinine excretion rate voids the test.
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.
Proteinuria of greater than 3.5 g /24 h /1.73 m 2 (between 3 and 3.5 g/24 h /1.73 m 2 is considered to be proteinuria in the nephrotic range) or greater than 40 mg/h/m 2 in children. [9] [10] The ratio between urinary concentrations of albumin and creatinine can be used in the absence of a 24-hour urine test for total protein. This coefficient ...