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Abstract Background Laboratory results are influenced by presence and severity of disease, as well as preanalytical factors, analytical variation, and biological variation. Biological variation data for urinary protein: creatinine ratio (UPC) and urine specific gravity (USG) in cats are lacking. Objectives Determine the biological variation of UPC and USG in cats. Animals Eighty healthy client‐owned cats. Methods Prospective study. Urine was collected on days 0, 14, and 56 from all 80 cats to investigate the persistence of borderline or overt proteinuria or suboptimal urine concentration. In 15 of these cats, urine was collected weekly from day 0 to 42 to calculate the index of individuality (II) and reference change value (RCV), and on days 56 and 57 to evaluate day‐to‐day variability of UPC and USG. Results Borderline or overt proteinuria (UPC ≥0.2) was present in 18/80 (23%) cats at baseline and persisted on 3 occasions in 2 months in 8/18 (44%) cats. Urine concentration was suboptimal at inclusion (USG 82% increase in UPC in a healthy cat is not solely attributable to physiological and analytical variation. For USG, a decrease of >36% is considered clinically relevant.

Abstract Background Urinalysis is necessary for the diagnostic evaluation of chronic kidney disease in cats. Performing cystocentesis is not always feasible, but data comparing urine obtained by cystocentesis in the clinic with voided samples collected at home are lacking in cats. Objectives To compare urinary protein:creatinine ratio (UPC) and urine specific gravity (USG) and to detect clinically relevant changes in proteinuria substage or urine concentration between urine collected at home and in‐clinic by cystocentesis in cats. Animals Ninety‐two healthy and diseased client‐owned cats. Methods Prospective study. Owners collected voided urine at home and within 1 to 15 hours, cystocentesis was performed in the clinic. Results In a subset of motivated owners, 55% succeeded in collecting urine at home. Overall, UPC was higher (mean ±SD difference = 0.09 ±0.22; P 0.4) was present in paired urine samples from 28% of cats. In 18% of cats, urine concentrating ability (USG

Background: Laboratory results are influenced by presence and severity of disease, as well as preanalytical factors, analytical variation, and biological variation. Biological variation data for urinary protein: creatinine ratio (UPC) and urine specific gravity (USG) in cats are lacking., Objectives: Determine the biological variation of UPC and USG in cats., Animals: Eighty healthy client-owned cats., Methods: Prospective study. Urine was collected on days 0, 14, and 56 from all 80 cats to investigate the persistence of borderline or overt proteinuria or suboptimal urine concentration. In 15 of these cats, urine was collected weekly from day 0 to 42 to calculate the index of individuality (II) and reference change value (RCV), and on days 56 and 57 to evaluate day-to-day variability of UPC and USG., Results: Borderline or overt proteinuria (UPC ≥0.2) was present in 18/80 (23%) cats at baseline and persisted on 3 occasions in 2 months in 8/18 (44%) cats. Urine concentration was suboptimal at inclusion (USG <1.035) in 8/80 (10%) cats and at all 3 time points during 2 months in 3/8 (38%) cats. The II of UPC and USG indicated intermediate individuality. The 1-sided RCV was 82% for UPC and 36% for USG. Proteinuria substage was identical on 2 consecutive days in 13/15 (87%) cats, and urine concentrating ability remained the same in all 15 cats., Conclusions and Clinical Importance: A >82% increase in UPC in a healthy cat is not solely attributable to physiological and analytical variation. For USG, a decrease of >36% is considered clinically relevant., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

Background: Urinalysis is necessary for the diagnostic evaluation of chronic kidney disease in cats. Performing cystocentesis is not always feasible, but data comparing urine obtained by cystocentesis in the clinic with voided samples collected at home are lacking in cats., Objectives: To compare urinary protein:creatinine ratio (UPC) and urine specific gravity (USG) and to detect clinically relevant changes in proteinuria substage or urine concentration between urine collected at home and in-clinic by cystocentesis in cats., Animals: Ninety-two healthy and diseased client-owned cats., Methods: Prospective study. Owners collected voided urine at home and within 1 to 15 hours, cystocentesis was performed in the clinic., Results: In a subset of motivated owners, 55% succeeded in collecting urine at home. Overall, UPC was higher (mean ±SD difference = 0.09 ±0.22; P < .001) and USG was lower (mean ±SD difference = -0.006 ±0.009; P < .001) in cystocentesis samples than in voided urine. Substantial agreement existed between sampling methods for UPC (weighted к = 0.68) and USG (к = 0.64) categories. A different proteinuria substage (UPC < 0.2, 0.2-0.4, >0.4) was present in paired urine samples from 28% of cats. In 18% of cats, urine concentrating ability (USG < or ≥1.035) differed between both samples., Conclusions and Clinical Importance: Home sampling of urine is a valid alternative to cystocentesis in cats. However, because clinically relevant differences in UPC and USG were present in 28% and 18% of cats, respectively, by the same collection method for monitoring each cat is advised., (© 2023 The Authors. Journal of Veterinary Internal Medicine published by Wiley Periodicals LLC on behalf of American College of Veterinary Internal Medicine.)

This study aimed at understanding the reasons veterinarians conduct a urinary protein/creatinine ratio (UPCR) in cats, correlating it with signalment, dipstick proteinuria tests, and urine specific gravity (USG) and assessing its role in chronic kidney disease (CKD) diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted between 2016 and 2018 in a veterinary teaching hospital and submitted to at least one UPCR measurement. A total of 140 cats were included: 35% non-proteinuric (UPCR < 0.2), 25% borderline proteinuric (0.2 < UPCR < 0.4), and 40% overtly proteinuric (UPCR > 0.4). In contrast to other studies, there was no association between UPCR and male reproductive status. UPCR was mainly requested for CKD diagnosis and monitoring. Correlation between UPCR and combined results from dipstick tests and USG was low and inconsistent. Proteinuric CKD cats had a worse outcome at both 6 (odds ratio (OR 4.04) and 12 months (OR 4.36)), and this finding was more pronounced for severely proteinuric cases in which the OR for death was 4.36 and 6.00 at 6 and at 12 months, respectively. In addition to reinforcing the negative prognostic value of proteinuria, this study stresses the low and the inconsistent agreement between UPCR and the combined results of dipstick tests and USG in cats.

Introduction: Nephrotic Syndrome is the commonest glomerular disease in children and is often characterized by multiple relapses. 24 hour urinary protein excretion is the accepted method used in quantification of proteinuria, but it's a time consuming, inconvenient and cumbersome method and difficult in very young children. Spot urine examination would be a simpler, easy, acceptable, and less time consuming method for detection of proteinuria in children. Aim: To evaluate the utility of protein: Creatinine ratio in random urine samples as a reliable diagnostic tool to quantify proteinuria and to determine the correlation of protein: Creatinine ratio to 24 hour protein excretion which is the gold standard reference method. Materials and Methods: The study was done on forty pediatric patients with nephrotic syndrome admitted in relapse, or presenting for the first time. Nephrotic syndrome was diagnosed on the basis of massive proteinuria (>40 mg/m2/hr), hypoalbuminemia (

Objective: To determine an optimal cutoff level of urinary protein-creatinine ratio (PCR) obtaining from 2 hours urine collection from women admitted with suspected preeclampsia for predicting significant proteinuria. Study design: Diagnostic test. Subject: Pregnant women with gestational age > 20 weeks who were admitted at Bangkok Metropolitan Administration Medical College and Vajira Hospital for evaluation of preeclampsia were studied prospectively. They were instructed to collect a 24-hour urine in two separate containers: one for the first 2 hours urine and the other for the following 22 hours urine specimens. Each sample was measured for volume, protein, and creatinine values. The first 2-hour urinary PCR and total 24-hour proteinuria were calculated. A receiver operating characteristic curve (ROC) of the 2-hour urinary PCR was constructed in order to determine the optimal cutoff level for estimate the degree of proteinuria. Results: A total of 182 out of 187 women completed the study; 137 (75%) had significant proteinuria. This study demonstrated moderate correlation between 2-hour urine protein and 24-hour urine protein(r=0.451). By using a 2-hour urinary PCR, the optimal cutoff level to predict significant proteinuria was ≥ 0.30 which yielded sensitivity, specificity, PPV, NPV and area under the ROC curve of 71.5%, 71.1%, 88.3%, 45.1% and 0.801 respectively. On the other hand, a cutoff level of ≥ 0.05 had a sensitivity of 100%, while the cutoff level of ≥ 2.0 offered 100% specificity. Conclusions: The 2-hour urinary PCR is not a good test to predict significant proteinuria due to its high false negative rate.

Objective: To determine an optimal cutoff level of urinary protein-creatinine ratio (PCR) obtaining from 6-hour urine collection specimens from women admitted with suspected preeclampsia for investigation of significant proteinuria. Study design: Diagnostic test. Subject: Pregnant women admitted for evaluation of preeclampsia were studied prospectively. They were instructed to collect a 24-hour urine in two separate containers: one for first six hours urine specimen, the other for following 18 hours urine specimen. Each sample was measured for volume, protein, and creatinine values. The first 6-hour urinary PCR and total 24-hour proteinuria were calculated. A receiver operating characteristic curve (ROC) of the 6-hour urinary PCR was constructed in order to determine the optimal cutoff level for estimate the degree of proteinuria. Results: A total of 120 out of 126 women completed the study; 96 (80%) had significant proteinuria. This study had shown moderate correlation between 6-hour urine protein and 24-hour urine protein.By using a 6-hour urinary PCR, the optimal cutoff level to predict significant proteinuria was ≥ 0.20 which yielded sensitivity, specificity, PPV, NPV and area under the ROC curve of 93.7%, 64.0%, 90.8%,72.7% and 0.788 respectively. On the other hand, a cutoff level of ≥ 0.10 had shown a sensitivity of 100% and specificity of 20.8%, while the cutoff level of ≥ 0.75 offered 100% specificity, but poor sensitivity of 55.7%. Conclusions: The 6-hour urinary PCR at ≥ 0.20 is the most appropriate value for diagnosis of significant proteinuria in preeclampsia.

Simple Summary: Urinary protein/creatinine ratio allows veterinary clinicians to quantify proteinuria, i.e., the amount of protein that is lost in urine. This ratio is commonly performed in daily practice for several medical reasons, namely the diagnosis and the monitoring of feline chronic kidney disease. This study aimed at understanding the main reasons to perform UPCR in cats, correlating it with signalment, exploring the agreement between UPCR, urine dipstick protein value, and urine specific gravity and assessing its role in chronic kidney disease diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted in a veterinary teaching hospital over two years and submitted to UPCR measurement. A total of 140 cats were included: 35% were non-proteinuric, 25% borderline proteinuric, and 40% showed overt proteinuria. This study found that UPCR is mainly requested for the diagnosis and the monitoring of chronic kidney disease and proteinuric cats with kidney disease have a worse outcome at 6-months and at 12-months. This study found and reinforced the negative prognostic value of UPCR in cats in comparison to dipstick and urine specific gravity. This study aimed at understanding the reasons veterinarians conduct a urinary protein/creatinine ratio (UPCR) in cats, correlating it with signalment, dipstick proteinuria tests, and urine specific gravity (USG) and assessing its role in chronic kidney disease (CKD) diagnosis and monitoring. A retrospective study was conducted, including medical data from cats consulted between 2016 and 2018 in a veterinary teaching hospital and submitted to at least one UPCR measurement. A total of 140 cats were included: 35% non-proteinuric (UPCR < 0.2), 25% borderline proteinuric (0.2 < UPCR < 0.4), and 40% overtly proteinuric (UPCR > 0.4). In contrast to other studies, there was no association between UPCR and male reproductive status. UPCR was mainly requested for CKD diagnosis and monitoring. Correlation between UPCR and combined results from dipstick tests and USG was low and inconsistent. Proteinuric CKD cats had a worse outcome at both 6 (odds ratio (OR 4.04) and 12 months (OR 4.36)), and this finding was more pronounced for severely proteinuric cases in which the OR for death was 4.36 and 6.00 at 6 and at 12 months, respectively. In addition to reinforcing the negative prognostic value of proteinuria, this study stresses the low and the inconsistent agreement between UPCR and the combined results of dipstick tests and USG in cats. [ABSTRACT FROM AUTHOR]

To evaluate the value of random urinary protein creatinine ratio in prediction of 24h proteinuria in hypertensive pregnancies. Method: Random urine samples and routine 24h urine collections were collected from hypertensive pregnant women (n=100). Reliability of random urinary protein-creatinine ratio was assessed by receiver operator characteristic (ROC) curve to detect significant proteinuria (300mg/day) using 24h. Urine protein as a gold standard. Forty six patients (46%) had significant proteinuria. The random protein creatinine ratio was correlated to 24h urine protein excretion (r2=0.777, P

Introduction: Early neonates (1-7-day-old) may develop acute kidney injury or acute renal failure due to functional (pre-renal, may be caused by decreased renal perfusion), intrinsic (renal, may be caused by acute insult), or obstructive (due to anatomic urinary tract obstruction) causes. Urinary protein estimation is important for diagnosis, follow-up and prognosis of disease. The Protein Creatinine Ratio (PCR) has been successfully used to establish proteinuria in different types of patients. Aim: This study was undertaken to establish normal PCR range in neonates, to rule out abnormal protein excretion in sick neonates. Materials and Methods: A total of 37 normal early neonates of age 0-3 days were enrolled for this study. Random spot urine samples were collected in paediatric urine bags for protein and creatinine estimation. Results: The urinary PCR varied between 0.1-0.8. The range of PCR values obtained was greater in 0-1 day old infants, compared to infants older than one day. Changes in PCR values were due to variations in the creatinine excretion. Conclusion: Urinary PCR values ≤ 0.8 indicate normal protein excretion. However, reference intervals of PCR should be established for narrow age groups in case of early neonates, e.g. 0-6h, 6-12h, 12-24h, 24-72h old babies.