| Objective:To evaluate the efficacy of Urine Albumin-creatinine ratio（UACR）and Urine Protein-creatinine ratio（UPCR）in predicting 24-hour urine total protein（24h UTP）,and to provide a theoretical basis for clinical prediction of 24h UTP in patients with kidney disease.Methods:From November 20,2020 to November 18,2021,202 patients were selected from the Department of Nephrology,Affiliated Hospital of Hebei University.After emptying the bladder urine at 6 o’clock in the morning one day before the patient’s visit,24-hour urine was collected and placed in a clean closed container.After the 24-hour urine sample was taken,the24-hour urine sample was taken on the day of treatment,and the urine volume was measured with a standard measuring cup.At the same time,the samples were taken to determine24h UTP and 24h urine total creatinine（24h UTCr）,and fresh middle urine was taken to determine UACR and UPCR.UACR was determined by immunoturbidimetry and sarcosine oxidase method.24h UTP using pyrogallol red molybdenum method;24h UTCr was measured by sarcosine oxidase method;UPCR was determined by pyrogallol red molybdenum method and sarcosine oxidase method.The data of UACR,UPCR,24h UTCr,24h UTP and serum creatinine were collected.Patients were divided into CKD1-2 group and CKD3-5 group according to glomerular filtration rate.Results:（1）There was a strong positive correlation between UACR and 24h UTP(r=0.912,P=2.31×10-79<0.05).There was a strong positive correlation between UPCR and 24h UTP,r=0.974,P=1.33×10-131<0.05.（2）The difference between UACR and UPCR in predicting 24h UTP was statistically significant(P=2.68×10-13<0.05).（3）The linear regression equation of UPCR and 24h UTP in patients with CKD1-2 stage had a statistically significant difference in its regression coefficient compared with patients with CKD3-5 stage,P=1.83×10-4<0.05.（4）The error of UPCR prediction of 24h UTP in patients with CKD1-2 stage was not statistically significant compared with patients with CKD3-5 stage,P=0.46>0.05.（5）When UPCR<515.3mg/g,the proportion of patients with CKD1-2 stage whose24h UTP was less than 1g was 98.63%;when UPCR>1388.1mg/g,the proportion of CKD1-2patients with 24h UTP greater than 1g was 100%;when the UPCR was<1842.3mg/g,the proportion of CKD1-2 patients with 24h UTP less than 3.5g was 100%;when UPCR>4962.5mg/g,the proportion of CKD1-2 patients with 24h UTP greater than 3.5g was 100%.（6）When UPCR<475.6mg/g,the proportion of patients with CKD stage 3-5 whose24h UTP was less than 1g was 100%;when the UPCR was>1532.9mg/g,the proportion of patients with CKD stage 3-5 whose 24h UTP was greater than 1g was 100%;When the UPCR was<2308.9mg/g,the proportion of patients with CKD stage 3-5 whose 24h UTP was less than 3.5g was 94.12%;when UPCR>7441.6mg/g,the proportion of CKD stage 3-5 patients with 24h UTP greater than 3.5g was 100%.Conclusions:1.Since the error of UACR in predicting 24h UTP in clinical practice is greater than that of UPCR,we should choose UPCR,rather than UACR,to predict 24h UTP in patients with kidney disease in clinical practice.2.Although the error of UPCR in predicting 24h UTP in patients with CKD1-2 was not significantly different from that in patients with CKD3-5,the regression coefficient of the linear regression equation of UPCR and 24h UTP in patients with CKD1-2 was higher than that in patients with CKD3-5,so different linear regression equations should be selected according to CKD stage when UPCR was used to predict 24h UTP in patients with kidney disease.3.When the UPCR of patients with chronic kidney disease is in a specific interval,UPCR can replace 24-hour urine protein quantitative examination;when the UPCR of patients with chronic kidney disease is outside a specific interval,24-hour urine protein quantitative examination is still required.In short,UPCR can partially replace 24-hour urine protein quantitative examination. |
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