Albumin-to-protein ratio in spot urine samples for analysis of proteinuria selectivity in chronic kidney disease

INTRODUCTION: The albumin-to-creatinine ratio and total protein-to-creatinine ratio in spot urine samples have already been validated as surrogates for 24-hour albuminuria and proteinuria measurements. Thus, we hypothesized that the type of proteinuria, detected by the electrophoretic pattern of 24-hour urine, could be predicted by the simple proportion of albumin in the total urine protein content, using the albumin-to-protein ratio (APR). Our study sought to validate the use of APR as a cheaper substitute for urinary protein electrophoresis (UPE). METHODS: Using different mathematical models, we compared, the albumin fraction in 24-hour urine samples by electrophoresis and the APR ratio in spot samples from 42 outpatients with chronic kidney disease (CKD). RESULTS: A strong log-order correlation r = 0.84 (0.75–0.92; 95% CI, p = 0.001) was observed between APR and the albumin fraction in the UPE. CONCLUSION: The APR can substitute electrophoresis in CKD outpatients.