Comparison of Urinary Protein Creatinine Index (uPCI) and Dipsticks for the Prediction of Renal Dysfunction in Chronic Cigarette Smokers.

ABSTRACT

Background: Proteinuria is recognized as one of the earliest sign of renal function deterioration in chronic smokers. Proteinuria occurs due to alteration in glomerular permeability and later due to failure of reabsorption of filtered protein by the tubular cells. Normally, most healthy adults excrete 20 – 150 mg of protein in urine over 24 hours. However, it is difficult to collect 24 hrs urine samples. Objectives: To advocate the use of PCI (protein creatinine index) in assessment of proteinuria and to compare dipstick result with PCI in the assessment of proteinuria in chronic cigarette smokers. Material & Methods: A total of 30 cigarette smokers and 40 age and sex matched controls were included for the study. A random specimen of urine collected from each cigarette smoker and non- smoker was tested quantitatively by manual sulfosalicylic acid colorimetric method for the estimation of protein concentration. Creatinine concentration in each specimen was measured by modified Jaffe’s method and the urinary PCI was calculated. Results: Normal range of PCI which has been established in this study is 50 to 259. Significantly higher amounts of protein were found to be excreted in urine in chronic smokers (9.313 ± 4.003 mg/dl) as compared to healthy non smokers (7.738 ± 2.05 mg/dl). On comparison of PCI between healthy non smoker and chronic smoker subjects, PCI has been found to be significantly elevated in chronic smokers (healthy non smoker- 118.32 ± 56.86, chronic smoker- 180.1 ± 88.23) (p=0.001). Conclusion: PCI of random urine sample can provide a very useful, simple and convenient method for the quantitative assessment of proteinuria to confirm the advent of kidney damage, avoiding the drawbacks of 24 hrs urine collection.