Correlation of spot urinary protein: Creatinine ratio and quantitative proteinuria in pediatric patients with nephrotic syndrome

INTRODUCTION: Nephrotic Syndrome is the commonest glomerular disease in children and is often characterized by multiple relapses. 24 hour urinary protein excretion is the accepted method used in quantification of proteinuria, but it's a time consuming, inconvenient and cumbersome method and difficult in very young children. Spot urine examination would be a simpler, easy, acceptable, and less time consuming method for detection of proteinuria in children. AIM: To evaluate the utility of protein: Creatinine ratio in random urine samples as a reliable diagnostic tool to quantify proteinuria and to determine the correlation of protein: Creatinine ratio to 24 hour protein excretion which is the gold standard reference method. MATERIALS AND METHODS: The study was done on forty pediatric patients with nephrotic syndrome admitted in relapse, or presenting for the first time. Nephrotic syndrome was diagnosed on the basis of massive proteinuria (>40 mg/m(2)/hr), hypoalbuminemia (<25 mg/l) and generalized oedema. Urine protein analysis was done using the sulphosalicylic acid method and creatinine estimation by a modified Jaffe's method. RESULT: The correation between spot protein and creatinine ratio and 24 hour proteinuria was statistically significant with r = 0.833 (P < 0.01) using Pearsons correlation coefficient. CONCLUSION: Spot protein creatinine ratio can be used as reliable test for detection of proteinuria in the pediatric age group in pateints with nephrotic syndrome.