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

Document Type : Original Article

Authors

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

Abstract

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.

Main Subjects

Daneshvar Medicine

Articles in Press, Accepted Manuscript
Available Online from 02 August 2025

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