Dilshad Ahmad Khan, Sohail Sabir, Tariq Mahmood, Ayaz Hussain Qureshi, Mumtaz Ahmed, Halim S A, Shujaat Hussain.
Monitoring of progression in Diabetic Nephropathy by use of protein: Creatinine index.
Pak J Pathol Jan ;16(2):45-51.

Objective: To assess the progression of nephropathy in diabetic patients by using protein: creatinine index in spot urine sample as compared to 24 hours urinary protein excretion rate. Study design: Comparative cross-sectional study. Subjects and methods: One hundred and fourteen patients, 45 male and 69 female, aged 18 to 67 years having proteinuria of more than 150 mg/day were included this study. Quantitative measurement of protein in the spot and 24h urine specimens were carried out by a method based on the formation of a red complex of protein with pyrogallal red in acidic medium, on Microlab 200®(Merck). Estimation of creatinine was done on Selectra®-2 (Merck) by Jaffe`s reaction. The urine protein: creatinine index was calculated by dividing the urine protein concentration (mg/L) by urine creatinine concentration (mmol/L) and multiplying by 10. Results: The protein: creatinine index in spot urine sample showed a reliable method of monitoring of progressive diabetic nephropathy as compared to 24 hours urine protein excretion rate. A significant correlation (r = 94) was found between the protein creatinine index and standard 24 hours urinary, protein excretion in these patients (p< 0.001). The index showed a significant negative correlation (r = 0.46) with glomerular filtration rate in progressive renal insufficiency in poorly controlled diabetics. Conclusion: The protein: creatinine index is quick and reliable method of estimation of proteinuria, to be used for monitoring of nephropathy leading to renal insufficiency in poorly controlled diabetics.

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