title: The efficacy of semi-quantitative urine protein-to-creatinine (P/C) ratio for the detection of significant proteinuria in urine specimens in health screening settings.
abstract: BACKGROUND
  Urine protein detection could be underestimated using the conventional dipstick method because of variations in urine aliquots. This study aimed to assess the efficacy of the semi-quantitative urine protein-to-creatinine (P/C) ratio compared with other laboratory methods.
  
  
  METHODS
  Random urine samples were requested from patients undergoing chronic kidney disease screening. Significant proteinuria was determined by the quantitative P/C ratio of at least 150 mg protein/g creatinine. The semi-quantitative P/C ratio, dipstick protein and quantitative protein concentrations were compared and analyzed.
  
  
  RESULTS
  In the 2932 urine aliquots, 156 (5.3 %) urine samples were considered as diluted and 60 (39.2 %) were found as significant proteinuria. The semi-quantitative P/C ratio testing had the best sensitivity (70.0 %) and specificity (95.9 %) as well as the lowest underestimation rate (0.37 %) when compared to other laboratory methods in the study. In the semi-quantitative P/C ratio test, 19 (12.2 %) had positive, 52 (33.3 %) had diluted, and 85 (54.5 %) had negative results. Of those with positive results, 7 (36.8 %) were positive detected by traditional dipstick urine protein test, and 9 (47.4 %) were positive detected by quantitative urine protein test. Additionally, of those with diluted results, 25 (48.1 %) had significant proteinuria, and all were assigned as no significant proteinuria by both tests.
  
  
  CONCLUSIONS
  The semi-quantitative urine P/C ratio is clinically applicable based on its better sensitivity and screening ability for significant proteinuria than other laboratory methods, particularly in diluted urine samples. To establish an effective strategy for CKD prevention, urine protein screening with semi-quantitative P/C ratio could be considered.
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Chih-Chun
authors: CC
authors: Chang
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Ming-Jang
authors: MJ
authors: Su
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Jung-Li
authors: JL
authors: Ho
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Yu-Hui
authors: YH
authors: Tsai
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Wei-Ting
authors: WT
authors: Tsai
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.
authors: Shu-Jene
authors: SJ
authors: Lee
authors: Division of Nephrology and Clinical Toxicology, Chang Gung Memorial Hospital, Lin-Kou Medical Center, Taoyuan, Taiwan, ROC.
authors: Tzung-Hai
authors: TH
authors: Yen
authors: Department of Clinical Pathology, Far Eastern Memorial Hospital, No. 21, Sec. 2, Nanya S. Road, Banqiao, New Taipei City, Taiwan, ROC.|School of Medical Laboratory Science and Biotechnology, Taipei Medical University, Taipei, Taiwan, ROC.|Graduate School of Biotechnology and Bioengineering, Yuan Ze University, Taoyuan, Taiwan, ROC.|Department of Medical Laboratory Science and Biotechnology, Yuanpei University of Medical Technology, Hsinchu, Taiwan, ROC.
authors: Fang-Yeh
authors: 0000-0002-9023-4198
authors: FY
authors: Chu
keywords: Chronic kidney disease; Health screening; Protein-to-creatinine ratio; Proteinuria