Evaluation of Urinary Protein to Creatinine Ratio as a Predictor of End-State Renal Disease

Objective: To evaluate the role of urinary protein to creatinine (P:C) ratio as a predictor of end-stage renal disease (ESRD) in renal failure patients.Material and Method: This study was conducted at Liaquat National Medical College Hospital, Karachi from Jan-Dec 2006 on 121 patients (77 males, 44 females) with acute renal failure (ARF) chronic renal failure (CRF). Clinical history, relevant investigations, renal status, dialysis routine and frequency were recorded. Random Urine samples (single void) were collected and the P:C ratio were calculated.Result: Out of 121 patients, 21 patients developed ESRD including 16 males (12 CRF, 4 ARF) and 5 females (all CRF). Statistical analyses shows no significant difference between sum of P:C ratio of CRF and ARF patients. However moderate significance (P 0.05) was noted among P:C ratio of ESRD patients when compared with males CRF and ARF groups. Similarly, female groups also showed non-significant difference, whereas ESRD patients (FCES), depicts moderate (P 0.05) significance when compared with female CRF and ARF groups. P:C ratio of males and females ESRD groups showed no significance difference. Mean P:C ratio in male CRF end stage category was 4.12 ± 0.82 (range 2.5 - 9.1) where as in male ARF end stage 3.78 ± 1.67 (range 1.80- 7.12). Mean P:C ratio in female CRF end stage category was 3.94 ± 0.79 (range 1.76 - 5.98).Conclusion: Patients with 1.0 of P:C ratio has developed ESRD. Higher the ratio of P:C, the more was risk of deterioration of clinical condition