Monitoring of progression in diabetic nephropathy by use of protein: Creatinine index

ABSTRACT

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. Comparative cross-sectional study. 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 [R] [Merck]. Estimation of creatinine was done on Selectra [R]-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. 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. 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