Correlation of spot urinary protein creatinine ratio and quantitative proteinuria in patients with nephrotic syndrome.

Abstract

Objective: To evaluate the correlation between spot urinary protein-creatinine ratio (PCR) and 24-hour quantitative proteinuria in patients with nephrotic syndrome. Study Design: Descriptive Cross-sectional study. Setting: Department of Nephrology, Khyber Teaching Hospital, Peshawar. Period: 11^th October 2025 to 10^th January 2026. Methods: A total of 144 adult patients (aged 18–70 years) with confirmed nephrotic syndrome were included. Demographic, clinical, and laboratory parameters were recorded. Total 24-hour urinary protein excretion was measured, and a simultaneous random spot urine sample was collected to calculate the protein-creatinine ratio (PCR). Data were analyzed using SPSS v26. Continuous variables were expressed as mean ± standard deviation, categorical variables as frequencies and percentages. Pearson’s correlation coefficient assessed the relationship between spot PCR and 24-hour proteinuria, with p≤0.05 considered significant. Results: The mean age of participants was 50.1 ± 13.0 years, with 57.6% males. The mean spot urinary PCR was 2.90 ± 1.28 mg/mg, and mean 24-hour proteinuria was 3.95 ± 1.48 g/day. Spot PCR showed a strong positive correlation with 24-hour proteinuria (r = 0.87, p<0.001). Subgroup analysis indicated that this correlation was consistent across gender, presence of hypertension, and diabetes mellitus. Conclusion: Spot urinary protein-creatinine ratio strongly correlates with 24-hour proteinuria in patients with nephrotic syndrome, supporting its use as a convenient and reliable alternative to timed urine collection in routine clinical practice.