Urology Book

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Urine Protein to Creatinine RatioAka: Urine Albumin to Creatinine Ratio

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  1. Indication
    1. Monitor persistant Proteinuria
  2. Efficacy
    1. More accurate than 24 Hour Urine Protein collection
    2. Most accurate if first morning void is used
  3. Technique: Random urine collection
    1. Urine Creatinine in mg
    2. Urine Protein in mg
    3. Calculate Urine Protein mg to Urine Creatinine mg Ratio
  4. Interpretation of Urine Protein to Urine Creatinine Ratio
    1. Child under age 2 years
      1. Normal Ratio <0.5
    2. Adults and children over age 2 years
      1. Normal ratio <0.2 grams protein per gram Creatinine
        1. Correlates with 0.2 g protein/day
      2. Nephrotic Ratio >3.5 (correlates with 3.5 g protein)
  5. Interpretation of Urine Albumin to Creatinine Ratio
    1. Normal Ratio (in general <30 mg/g is normal)
      1. Men: < 0.017 (or 17 mg albumin to 1 gram Creatinine)
      2. Women: <0.025 (or 25 mg albumin to 1 gram Creatinine)
    2. Microalbuminuria: 30-300 mg albumin/g Creatinine
    3. Macroalbuminuria: >300 mg albumin/g Creatinine
  6. References
    1. Ruggenenti (1998) BMJ 316:504
    2. (2002) Am J Kidney Dis 39:S1

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