Usefulness of spot urine protein creatinine ratio in the diagnosis of childhood nephrotic syndrome

Nephrotic syndrome is primarily a pediatric disorder,characterized by edema,heavy proteinuria,hypoalbuminemia,hypercholesteremia and normal renal functions. in patients of nephrotic syndrome,urinary protein excretion exceeds more than 1gms/m2/24 hours. conventionally,protein loss in urine has been estimated in twenty four hour urine samples but this is time taking,inapt and inaccurate approach,more so in infants. in comparison to this,the protein creatinine ratio in a spot urine sample is commodious,speedy and dependable method of estimation of proteinuria. objective: to evaluate the accuracy of protein creatinine ratio in spot urine sample in the diagnosis of nephrotic syndrome in children considering twenty four hour urinary protein excretion as standard. setting: department of pediatrics,azra naheed medical college lahore at punjab social security health management company hospital lahore. duration of study: two years i.e,from january 2013 to december 2014. sample size: ninety patients with nephrotic syndrome admitted in ward who met the inclusion criteria were included in the study group. sampling technique: convenient non-probability sampling. study design: this was a cross-sectional validational study. results: out of 90 cases in this study,43 (47.7%) patients were between 1-5 years,34 (79%) male and 9 (20.4%) were female. thirty four (37.7%) were between 6-10 years,26 (78.8%) male and 8 (21.2%) were female. thirteen (14.4%) patients were between 11-14 years,8 (61.5%) male and 5 (38.5%) were female. in all 90 (100%) patients of nephrotic syndrome,urine dipstick test for protein was positive in the range between 3+ve to 4+ve. the twenty four hour urinary protein excretion was found to be more than 1gm/dl in all (100%) patients. in all patients,protein creatinine ratio in spot urine sample was calculated and it was found that in 85 (94.4%) patients,it was more than 3. conclusion: the protein creatinine ratio in a spot urine sample is convenient,speedy and dependable method of estimation of proteinuria when compared to twenty four hour urinary protein excretion. © 2015,pakistan pediatric journal. all rights reserved.