Journal of Capital Medical University ›› 2024, Vol. 45 ›› Issue (5): 831-837.doi: 10.3969/j.issn.1006-7795.2024.05.013

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Consistency evaluation of urine PCR and 24-h urine protein quantification in urine protein evaluation of glomerular disease patients

Chen Xianghui 1,2，Jia Ting 1,2，Yang Ying 1,2，Li Yan 1,2，Wei Shizhuo 1,2,Wang Jiaqi 1,2，Feng Yingying 1,2， Ma Fangxia1,2， Chen Zhao1,2，Wang Li 1,2, Fu Rongguo 1,2*   

  1. 1.Department of Nephrology, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China；2.Urology and Nephrology Hospital of the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China
  • Received:2024-07-29 Online:2024-10-21 Published:2024-10-18
  • Supported by:
    This study was supported by National Natural Science Foundation of China（82000699，82170697）， the Key Social Development Project of Shaanxi Provincial Department of Science and Technology (2023-YBSF-330), the Visiting and Training Program for Leading Figures in the Health and Hygiene Discipline of Shaanxi Province.

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Abstract: Objective  To evaluate the consistency between urine protein/creatinine ratio (PCR) and 24-h urine total protein (24-h UTP) in measuring proteinuria levels in patients with glomerular diseases. Methods  Patients with acute and chronic glomerulonephritis, nephrotic syndrome, and other glomerular diseases admitted to the Second Affiliated Hospital of Xi'an Jiaotong University from March 2024 to July 2024 were selected as the research subjects. Clinical data such as age, gender, primary disease, urine output, blood routine, liver and kidney function, and blood lipids were collected. The results of morning urine PCR and 24-h UTP were also recorded. Multiple linear regression was applied to select indicators that significantly affect PCR and 24-h UTP. Patients were grouped based on these indicators, and Bland-Altman analysis and intraclass correlation efficient（ICC）were applied to evaluate the consistency of the two measurement indicators in each group.  Results  A total of 220 patients were included in this study, including 129 males and 91 females, with an average age of （53.21±17.68） years old. The Spearman correlation coefficient between 24-h UTP and PCR was 0.83 (P ＜0.001). Multiple linear regression showed that urine volume and serum albumin（ALB） levels could affect the results of 24-h UTP, while PCR results were not affected by urine volume but were influenced by estimated glomerular filtration rate（eGFR） and ALB levels. Bland Altman analysis suggests that for patients with urine output of 1 500-2 500 mL, eGFR between 30-89 mL·(min·1.73 m2)－1, or ALB levels ≥ 30g/L, the two indicators have good consistency in detecting urinary protein levels. ICC further quantified the consistency of two indicators in each group, suggesting that ALB levels and urine volume may be factors affecting the consistency of the two indicators. Conclusions  Although there is a significant correlation between urinary PCR and 24-h UTP results, their consistency and mutual substitutability require comprehensive judgment based on the patients urine volume, ALB, and eGFR levels.

Key words: urine protein/creatinine ratio, 24-h urine total protein, consistency

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