Comparison of Spot Urine vs 24-Hours Urine in Assessment of Proteinuria in Patients with  Type 2 Diabetes Mellitus

Muhammad Zain Abideen; Rizwan Yusuf; Zaboor Barki; Muhammad Ali Khan; Nadeem Umar; Minahil Nadeem

doi:10.51253/pafmj.v75i5.10722

Authors

Muhammad Zain Abideen Department of General Medicine, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Rizwan Yusuf Department of General Medicine, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Zaboor Barki Department of General Medicine, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Muhammad Ali Khan Department of General Medicine, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Nadeem Umar Department of General Surgery, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan
Minahil Nadeem Department of General Medicine, Combined Military Hospital Abbottabad/National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v75i5.10722

Keywords:

Albuminuria, Diabetes Mellitus, Nephropathy, Proteinuria, Spot uPCR, 24 Hour Urine Protein

Abstract

Objective: To assess the correlation between spot urine test (Spot Protein/Creatinine Ratio) and 24-hours urine protein analysis in assessing proteinuria among patients with Type 2 diabetes.

Study Design: Cross-Sectional Study.

Place and Duration of Study: Department of Medicine, Combined Military Hospital, Abbottabad Pakistan, from Oct 2022 to Mar 2023.

Methodology: Eighty patients of either gender with diagnosed Type 2 Diabetes Mellitus presenting to CMH Abbottabad during study period with evidence of proteinuria were included in the study. 24-hours urine sample was obtained for analysis of 24 hours protein excretion. Urine was also tested for spot protein creatinine ratio in all patients. Association of 24-hour urine and spot urine protein levels was observed and represented by ROC curve and Pearson's correlation.

Results: Total 80 diabetic patients with proteinuria analyzed with mean age of 53.51±6.34 years including 45(56.3%) males and 35(43.8%) females. The mean duration of diabetes was 7.75±1.95 years with mean fasting sugar 183.88±36.33 mg/dL and HbA1c 9.46±1.30%. The observed mean 24-hour urinary protein was 1194.60±398.39 mg/day and mean spot uPCR was 1005.49±446.84 mg/mmol. An affirmative correlation was noted in 24-hours urine protein and uPCR (r value= 0.604; p<0.001). The ROC curve with respect to age groups showed p=0.143 and =0.851 for 24-hours urine protein and spot uPCR respectively.

Conclusion: 24-hour urinary protein and urine protein/ creatinine ratio (uPCR) were equally reliable for proteinuria detection in patients with Type 2 diabetes mellitus. However, spot uPCR is fast, convenient and easily available substitute for 24-hour urine protein in healthcare facilities.

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