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Evaluation of variability of proteinuria indices

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Abstract

We compared several indices of proteinuria, namely protein concentration, hourly protein excretion rate (Up/h) and protein/creatinine ratio (Up/Ucr) in single voided urine samples as well as 24 h-urinary protein excretion (24 h-Up), in 44 children, aged 4–16 years, with varying degrees of urinary protein excretion. We found an excellent correlation between Up/h and Up/Ucr in early morning samples. These two indices in early morning samples had excellent correlation with 24 h-Up, comparable to those in any other urine sample of the day. Among daytime samples, Up/h varied widely, in contrast to Up/Ucr, which had significantly less variability. We analysed six early morning and six bedtime samples from 39 of these subjects, and found smaller coefficients of variation for individual patient's indices in morning samples. Up/h was more variable than Up/Ucr, especially in bedtime samples. Urinary protein concentration had a poorer correlation with 24 h-Up and was more variable than any other index. We conclude that the Up/Ucr in early morning samples, which has the advantages both of simplicity and low day-to-day variability in a given patient, is a superior index of proteinuria.

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References

  1. Abuelo JG (1983) Proteinuria: diagnostic principles and procedures. Ann Intern Med 98: 186–191

    Google Scholar 

  2. Schuck O (1984) Proteinuria. (ed) Examination of kidney function. Martinus Nijhoff, Boston, pp 85–107

    Google Scholar 

  3. Kassirer JP, Gennari FJ (1979) Laboratory evaluation of renal function. In: Earley LE, Gottschalk CW (eds) Straus and Welts diseases of the kidney, 3rd edn. Little Brown, Boston, pp 41–91

    Google Scholar 

  4. International Study of Kidney Disease in Children (1978) The nephrotic syndrome in children. Prediction of histopathology from clinical and laboratory characteristics at the time of diagnosis. Kidney Int 13: 159–165

    Google Scholar 

  5. Ginsberg JM, Chang BS, Matarese RA, Garella S (1983) Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med 309: 1543–1546

    Google Scholar 

  6. Shaw AB, Risdon P, Lewis-Jackson JD (1983) Protein creatinine index and Albustix in assessment of proteinuria. Br Med J 287: 929–932

    Google Scholar 

  7. Houser M (1984) Assessment of proteinuria using random urine samples. J Pediatr 104: 845–848

    Google Scholar 

  8. Davies AG, Postlethwaite RJ, Price DA, Burn JL, Houlton CA, Fielding BA (1984) Urinary albumin excretion in school children. Arch Dis Child 59:625–630

    Google Scholar 

  9. Houser MT, Jahn MF, Kobayashi A, Walburn J (1986) Assessment of urinary protein excretion in the adolescent: effect of body position and exercise. J Pediatr 109: 556–561

    Google Scholar 

  10. Yoshimoto M, Fujisawa S, Sudo M (1988) Percutaneous renal biopsy well-visualized by orthogonal ultrasound application using linear scanning. Clin Nephrol 30:106–110

    Google Scholar 

  11. McElderry LA, Tarbit IF, Cassells-Smith AJ (1982) Six methods for urinary protein compared. Clin Chem 28:356–360

    Google Scholar 

  12. Wallenstein S, Zucker CL, Fleiss JL (1980) Some statistical methods useful in circulation research. Circ Res 47:1–9

    Google Scholar 

  13. Speck AJ, Thissen JTNM, Schrijver J (1986) Urinary excretion of 3-methylhistidine and creatinine by healthy Dutch children during day and night. The influence of age and sex. J Clin Chem Clin Biochem 24:465–470

    Google Scholar 

  14. Ueda N (1977) Renal clearance tests in the exercise loading and the postural loading for a prediction of the activity of the glomerular lesion of glomerulonephritis. Jpn J Nephrol 19:683–701

    Google Scholar 

  15. King SE (1957) Postural adjustments and protein excretion by the kidney in renal disease. Ann Intern Med 46:360–377

    Google Scholar 

  16. Sharma BK, Gandhi V, Pillay VKG, Smith EC, Dunea G (1971) Effect of standing on proteinuria in renal disease. Lancet I:369–371

    Google Scholar 

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Yoshimoto, M., Tsukahara, H., Saito, M. et al. Evaluation of variability of proteinuria indices. Pediatr Nephrol 4, 136–139 (1990). https://doi.org/10.1007/BF00858824

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  • DOI: https://doi.org/10.1007/BF00858824

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