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Chemical Pathology – “protein to creatinine ratio”
Notes
Indications for testing:
Indications for testing in being pregnant (NICE NG133):
Pattern necessities
An early morning urine pattern in a 6mL plain urine tube
Storage/transport
Ship at ambient temperature to the laboratory. If unavoidable, samples could also be saved refrigerated in a single day.
Required info
Related medical particulars together with purpose for the check, any present UTI or haematuria and whether or not the pattern is an early morning urine.
Turnaround occasions
Outcomes are usually obtainable inside 3 days of receipt by the laboratory.
The check may be ordered as an pressing request.
Reference ranges
Urine ACR
Grownup reference vary (NICE CG182):
<3 mg/mmol: normal to mildly increased 3 - 30 mg/mmol: moderately increased, relative to young adult level. Regard a confirmed ACR of 3 mg/mmol or more as clinically important proteinuria. >30.0 mg/mmol: severely elevated, together with nephrotic syndrome (urine ACR often >220 mg/mmol)
Urine ACR in being pregnant (NICE NG133): if utilizing albumin:creatinine ratio as a substitute for protein:creatinine ratio to diagnose pre-eclampsia in pregnant girls with hypertension, use 8 mg/mmol as a diagnostic threshold. If the result’s 8 mg/mmol or above and there may be nonetheless uncertainty in regards to the analysis of pre-eclampsia, take into account re-testing on a brand new pattern, alongside medical overview. Interpret proteinuria measurements for pregnant girls within the context of a full medical overview of signs, indicators and different investigations for pre-eclampsia.
Urine PCR
Urine PCR in being pregnant (NICE NG133): if utilizing protein:creatinine ratio to quantify proteinuria in pregnant girls, use 30 mg/mmol as a threshold for important proteinuria. If the result’s 30 mg/mmol or above and there may be nonetheless uncertainty in regards to the analysis of pre-eclampsia, take into account re-testing on a brand new pattern, alongside medical overview. Interpret proteinuria measurements for pregnant girls within the context of a full medical overview of signs, indicators and different investigations for pre-eclampsia.
Issues related to sampling:
Excessive urine proteins however regular ACR:
Additional info
Lab Checks On-line Albumin:Creatinine Ratio
NICE Guideline: Power Kidney Illness pathway (CG182, 2014)
NICE Guideline: Hypertension in being pregnant: analysis and administration (NG133, 2019)
G-Care Steering: CKD
Web page final up to date: 09/11/2020
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“protein to creatinine ratio”