ارتباط بین نسبت پروتئین به کراتینین ادرار رندوم با پروتئین و کراتینین ادرار 24 ساعته در کودکان مبتلا به سندروم نفروتیک Correlation Between Protein and Creatinine Ratio of Random Urine with Protein and Creatinine 24-hour Urine in Children with Nephrotic Syndrome

نوع مقاله : مقاله پژوهشی

نویسندگان

1 گروه بیماری‌های کودکان، دانشکده پزشکی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

2 مرکز تحقیقات نفرولوژی و پیوند کلیه، پژوهشکده تحقیقات بالینی، دانشگاه علوم پزشکی ارومیه، ارومیه، ایران.

چکیده

مقدمه و هدف: پروتئین ادرار 24 ساعته استاندارد طلایی برای تشخیص سندروم نفروتیک است. با این‌حال، کارایی نسبت کراتینین به پروتئین تصادفی ادرار (UPr/UCr) به‌عنوان جایگزین مطمئن برای پروتئین ادرار 24 ساعته نامشخص است. این مطالعه با هدف تعیین ارتباط بین نسبت UPr/UCr با سطح پروتئین و کراتینین ادرار 24 ساعته در کودکان مبتلا به سندروم نفروتیک انجام شد.
مواد و روش‌ها: این مطالعه به صورت مقطعی-تحلیلی انجام و 75 کودک مبتلا به سندروم نفروتیک (موارد جدید و عود) بستری شده در بیمارستان شهید مطهری ارومیه (1402–1401) وارد مطالعه شدند. اولین نمونه ادرار تصادفی صبحگاهی و در همان روز ادرار 24 ساعته جمع‌آوری و کراتینین و پروتئین آن اندازه‌گیری شد. داده‌ها با استفاده از نرم افزار SPSS و آزمون‌های من‌ویتنی  و ضریب همبستگی اسپیرمن آنالیز شدند.
نتایج: بین نسبت UPr/UCr و پروتئین 24 ساعته در کل بیماران و در دختران و پسران و بین نسبت UPr/UCr و نسبت پروتئین به کراتینین ادرار 24 ساعته همبستگی مستقیم و معنی‌داری وجود داشت. در گروه سنی بیشتر از 4 سال، ارتباط مستقیم و معنی‌داری بین نسبت UPr/UCr و پروتئین 24 ساعته و همچنین نسبت UPr/UCr و نسبت پروتئین به کراتینین 24 ساعته وجود داشت، اما در گروه سنی کمتر یا مساوی 4 سال این همبستگی معنی‌دار نبود.
نتیجه‌گیری: نسبت UPr/UCr با توجه به مزایای آن از نظر هزینه، زمان و راحتی بیمار می‌تواند به‌عنوان روشی جایگزین برای تشخیص سندرم نفروتیک در کودکان استفاده شود. با این‌وجود، تفسیر نتایج تست ادرار رندوم، به‌ویژه در کودکان زیر 4 سال، باید با احتیاط انجام شود.
Background and Objectives: The 24-hour urine protein measurement is the gold standard for diagnosing nephrotic syndrome. However, the efficacy of the ratio of creatinine to spot urine protein (UPr/UCr) as a substitute for 24-hour urine protein remains uncertain. This study aimed to investigate the relationship between the UPr/UCr ratio and protein and creatinine levels in 24-hour urine samples from children with nephrotic syndrome.
Materials and Methods: This cross-sectional study included 75 children with nephrotic syndrome (new and recurrent cases) admitted to Shahid Motahari Hospital in Urmia (2023-2024). Spot urine samples from the first morning and subsequent 24-hour urine collection were obtained, and creatinine and protein levels were measured. Data analysis was performed using the SPSS software, employing Mann-Whitney U tests and Spearman's correlation coefficients.
Results: A significant correlation was observed between the UPr/UCr ratio and 24-hour protein, and between the UPr/UCr ratio and the 24-hour urine protein-to-creatinine ratio in the total patient population and both male and female subgroups. In patients older than 4 years, a significant correlation was noted between the UPr/UCr ratio and 24-hour protein levels and between the UPr/UCr ratio and the 24-hour urine protein to creatinine ratio. However, in patients four years and younger, this correlation was not statistically significant.
Conclusion: Given its advantages of cost-effectiveness, time efficiency, and patient convenience, the UPr/UCr ratio may be considered an alternative method for diagnosing nephrotic syndrome in children. Nevertheless, the interpretation of spot urine test results, particularly in children under four years of age, should be approached cautiously.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Association Between Spot Urine Protein/Creatinine Ratio with 24-hour Urine Protein and Creatinine content in Children with Nephrotic Syndrome

نویسندگان [English]

  • Hashem Mahmoudzadeh 1
  • Mohammad Valizadeh 2
  • Maryam Tavakkoli 1
1 Department of Pediatrics, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2 Nephrology and Kidney Transplant Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
چکیده [English]

Background and Objectives: The 24-hour urine protein measurement is the gold standard for diagnosing nephrotic syndrome. However, the efficacy of the ratio of creatinine to spot urine protein (UPr/UCr) as a substitute for 24-hour urine protein remains uncertain. This study aimed to investigate the relationship between the UPr/UCr ratio and protein and creatinine levels in 24-hour urine samples from children with nephrotic syndrome.
Materials and Methods: This cross-sectional study included 75 children with nephrotic syndrome (new and recurrent cases) admitted to Shahid Motahari Hospital in Urmia (2023-2024). Spot urine samples from the first morning and subsequent 24-hour urine collection were obtained, and creatinine and protein levels were measured. Data analysis was performed using the SPSS software, employing Mann-Whitney U test and Spearman's correlation coefficients.
Results: A significant correlation was observed between the UPr/UCr ratio and 24-hour protein, and between the UPr/UCr ratio and the 24-hour urine protein-to-creatinine ratio in the total patient population and both male and female subgroups. In patients older than 4 years, a significant correlation was noted between the UPr/UCr ratio and 24-hour protein levels and between the UPr/UCr ratio and the 24-hour urine protein to creatinine ratio. However, in patients four years and younger, this correlation was not statistically significant.
Conclusion: Given its advantages of cost-effectiveness, time efficiency, and patient convenience, the UPr/UCr ratio may be considered an alternative method for diagnosing nephrotic syndrome in children. Nevertheless, the interpretation of spot urine test results, particularly in children under four years of age, should be approached cautiously.

مراجع

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دانشور پزشکی
دوره 33، شماره 1 - شماره پیاپی 176
فروردین و اردیبهشت 1404
صفحه 23-30

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