Albumin-to-protein ratio in spot urine samples for analysis of proteinuria selectivity in chronic kidney disease. 2023

Miguel Augusto Martins Pereira, and Roger Freitas Ramirez Jordan, and Jorge Paulo Strogoff de Matos, and José Carlos Carraro-Eduardo
Universidade Federal Fluminense, Escola de Medicina, Niterói, RJ, Brazil.

BACKGROUND The albumin-to-creatinine ratio and total protein-to-creatinine ratio in spot urine samples have already been validated as surrogates for 24-hour albuminuria and proteinuria measurements. Thus, we hypothesized that the type of proteinuria, detected by the electrophoretic pattern of 24-hour urine, could be predicted by the simple proportion of albumin in the total urine protein content, using the albumin-to-protein ratio (APR). Our study sought to validate the use of APR as a cheaper substitute for urinary protein electrophoresis (UPE). METHODS Using different mathematical models, we compared, the albumin fraction in 24-hour urine samples by electrophoresis and the APR ratio in spot samples from 42 outpatients with chronic kidney disease (CKD). RESULTS A strong log-order correlation r = 0.84 (0.75-0.92; 95% CI, p = 0.001) was observed between APR and the albumin fraction in the UPE. CONCLUSIONS The APR can substitute electrophoresis in CKD outpatients.

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