The association between albumin to creatinine ratio and total protein to creatinine ratio in patients with chronic kidney disease.
OBJECTIVE
Although albumin to creatinine ratio (ACR) and total protein to creatinine ratio (PCR) in random urine have been supposed as alternatives to 24-h urine measurements, there are few studies comparing these tests in CKD patients. Therefore, we investigated the relations between ACR and PCR in CKD patients and the factors that affect the relationship.


METHODS
We enrolled 808 patients with CKD prospectively and compared ACR, PCR and urine dipstick test in random urine.


RESULTS
Albuminuria was well correlated with proteinuria (β = 1.114, p < 0.001). The association between albuminuria and proteinuria was greater in patients with following characteristics: dipstick protein positive compared with negative (p < 0.001 for interaction), urine creatinine level ≥ 60 mg/dl compared with < 60 mg/dl (p = 0.024 for interaction) and estimated glomerular filtration rate < 60 ml/min/1.73 m2 compared with ≥ 60 ml/min/1.73 m2 (p = 0.040 for interaction). However, the association between albuminuria and proteinuria was not affected by sex, the presence of diabetes, or old age (≥ 60 years).


CONCLUSIONS
Both ACR and PCR in random urine are correlated well and can be used for monitoring of protein excretion in CKD patients, alternatively. However, the correlation is not strong in patients with low amount of protein excretion or with low urinary creatinine concentration.
Department of Internal Medicine , Chungbuk National University Hospital, Cheongju.
Sun Moon
SM
Kim
Chang-Hoon
CH
Lee
Jung Pyo
JP
Lee
Yun Kyu
YK
Oh
Yon Su
YS
Kim
Suhnggwon
S
Kim
Chun Soo
CS
Lim
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine*; D003404:Creatinine / Q000652:urine*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D011507:Proteinuria / Q000652:urine*; D051436:Renal Insufficiency, Chronic / Q000652:urine*
D003404:Creatinine