title: Comparison of urinary protein: creatinine index and dipsticks for detection of microproteinuria in diabetes mellitus patients.
abstract: BACKGROUND
  Proteinuria has been recognized as one of the earliest signs of renal function deterioration in Diabetes mellitus. Proteinuria occurs due to alterations in the glomerular permeability and later, due to a failure in the reabsorption of filtered protein by the tubular cells. Normally, most of the healthy adults excrete 20-150 mg of protein in urine over 24 hours.
  
  
  OBJECTIVE
  To find out the normal urinary Protein Creatinine Index (PCI) in healthy subjects, to compare the urinary PCI of diabetic patients with that of healthy subjects and to compare the urinary PCI with dipsticks for the detection of microproteinuria.
  
  
  METHODS
  This study was conducted on 28 type 2 Diabetes mellitus patients and 40 age and sex matched healthy controls. Freshly collected urine samples were tested qualitatively for the presence of proteinuria by Heller's test, the sulfosalicylic acid test, heat-coagulation tests and urine dipsticks. Later on, the results were compared by performing a quantitative analysis of the protein in the spot urine samples by the sulfosalicylic acid method. A quantitative analysis of creatinine was done by the modified Jaffe's test. The PCI was calculated for each of the participant in the study. The Mean and Standard Deviation (SD) of the PCI was calculated and it was compared between the two groups.
  
  
  RESULTS
  The normal range of the PCI which was established in this study was 60 to 220. Significantly higher amount of proteins were found to be excreted in urine in diabetic patients (25.37 ± 12.51 mg/dl) as compared to those in normal subjects (8.93 ± 3.54 mg/dl). On comparison of the PCI between the controls and the diabetic subjects, it was found to be significantly elevated in the Diabetes mellitus patients (controls = 114.65 ±47.97 and in the diabetic patients =373.04 ± 98.53) (p < 0.001).
  
  
  CONCLUSIONS
  The PCI of a random urine sample can provide a very useful, simple and convenient method for the quantitative assessment of proteinuria, to judge the extent of kidney damage and for avoiding the drawbacks of the 24 - hr urine collections.
authors.affiliation: MSc. Medical Biochemistry, Demonstrator, Department of Biochemistry, Rama Medical College , Ghaziabad (U.P.), India .
authors.forename: Anoop
authors.initials: A
authors.lastname: Kumar
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Kapoor
authors.forename: R C
authors.initials: RC
authors.lastname: Gupta
keywords: Diabetes mellitus; Protein-creatinine index; Proteinuria