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Abstract: SA-PO720

Clinical Verification of Urine Protein/Creatinine Ratio Instead of 24-Hour Urinary Protein Evaluated the Different Levels of Proteinuria in Children

Session Information

Category: Pathology and Lab Medicine

  • 1602 Pathology and Lab Medicine: Clinical

Authors

  • Huang, Yanjie, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
  • Yang, Xiaoqing, The First Affiliated Hospital of Henan University of Traditional Chinese Medicine, Zhengzhou, China
Background

To evaluate the correlation and consistency between urine protein/creatinine ratio (UPCR) and 24 hour urinary protein (24hUP) in children, and to determine cutoff values of UPCR relative to 24hUP at 150mg(>150mg is pathological proteinuria) and 50mg/kg (>50mg/kg is nephrotic-range proteinuria) respectively.

Methods

370 children were enrolled, including 85 normal children, 109 Henoch-Schönlein purpura nephritis, 167 nephrotic syndrome, 5 IgA nephropathy, and 4 lupus nephritis. These patients were divided into three groups: normal group: 24hUP≤150mg, n =85; non-nephrotic range proteinuria group: 150mg<24hUP≤50mg/kg, n =120; nephrotic-range proteinuria group: 24hUP>50mg/kg, n =165. Clinical symptoms and laboratory examimation data were collected. The correlation between UPCR and 24hUP were evaluated by spearman correlation analysis. The consistency between UPCR and 24hUP was analyzed by Bland-Altman technique. The cutoff values of UPCR in predicting non-nephrotic range proteinuria group and nephrotic-range proteinuria were determined using receiver operating characteristics (ROC) curve, respectively.

Results

UPCR was positively correlated with 24hUP (r =0.885, P<0.01). Bland-altman diagrams showed that UPCR and 24hUP had good consistency, and >95% spots of UPCR and 24hUP were within the 95% consistency area. Relative to 24hUP (150mg), the cutoff value (0.23g/g Cr) with the highest sensitivity (92.8%) and specificity (92.9%) was close to the UPCR>0.2g/g Cr proposed by American rheumatic society in 2006 as the diagnositic standard of pathological proteinuria. Relative to 24hUP (50mg/kg), the cutoff value (2.09g/g Cr) with the highest sensitivity (94.5%) and specificity (88.6%) was close to the UPCR>2.0g/g Cr proposed in 2012 KDIGO guidelines as the diagnositic standard of nephrotic syndrome and nephrotic-range proteinuria.

Conclusion

There are good correlation and consistency between UPCR and 24hUP. UPCR can be used to evaluate the different levels of proteinuria in children.