Protein creatinine index: A possible predictor of nephropathy in hypertensives, in Northern India.
BACKGROUND
>33% of the hypertensive Indians develops nephropathy. Proteinuria is an early indicator of nephropathy. Gold standard for determining proteinuria is 24-hour urinary protein excretion which is a troublesome task with poor patient compliance. Protein creatinine index (PCI) in a random urine sample has been advocated by some researchers as an alternative approach. Aim of this study was to evaluate the association of PCI with the severity and duration of hypertension, in North Indian population.


METHODS
120 Stage-1 hypertensives, 120 stage-2 hypertensives, 40 pre-hypertensives and 40 normotensives were included in this study. 240 Hypertensive subjects were divided into 3 sub-groups based on duration: <5years (n=80), 5-10years (n=80) and >10years (n=80). Urinary protein was estimated by sulfosalicylic acid method and urinary creatinine was measured using modified Jaffe's method. PCI was measured as described by Shaw et al. Data was statistically analyzed by ANOVA and Pearson's correlation test using SPSS v20.


RESULTS
PCI of stage-2 hypertensives (157.83±51.53) was significantly higher than normo-, pre- and stage-1 hypertensives. PCI of stage-1 hypertensives (134.15±46.04) was significantly higher than normotensives only. PCI of hypertensives for 5-10years (137.29±49.55) and >10years (181.85±47.42) was significant higher than controls and pre-hypertensives. PCI showed significantly stronger association with severity (r=0.595) and duration (r=0.745) of hypertension as compared to urinary protein and creatinine concentration. Data also suggest that the risk of renal injuries against the backdrop of raised blood pressure (BP) increases after 5years of hypertension.


CONCLUSIONS
PCI can be used as a screening tool for early detection of hypertensive nephropathy. PCI monitoring should be incorporated in the routine checkup module of patients suffering from hypertension for >5years.
Department of Biochemistry, J. N. Medical College, AMU, Aligarh, India. Electronic address: akif12345@gmail.com.
Akif
A
Ahsan
Department of Biochemistry, NIMS Medical College, Jaipur, India.
Kush
K
Manna
Department of Biochemistry, NIMS Medical College, Jaipur, India.
Gajraj S
GS
Yadav
Department of Physiology, Subharti Medical College, Dehradun, India.
Arsalan
A
Moinuddin
Department of Physiology, Government Doon Medical College, Dehradun, India.
Aquil
A
Ahmad
Department of Biochemistry, NIMS Medical College, Jaipur, India.
R C
RC
Gupta
Department of Biochemistry, HIMSR, Jamia Hamdard, N. Delhi, India.
Sana
S
Alam
D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D007194:India; D009401:Nephrosis / Q000175:diagnosis* / Q000209:etiology; D011237:Predictive Value of Tests; D012720:Severity of Illness Index; D013997:Time Factors
D003404:Creatinine
Hypertension; Hypertensive nephropathy; Protein creatinine index; Proteinuria