AB0299 QUANTITATIVE EVALUATION OF PROTEINURIA WITH URINALYSIS TEST AND COMPARING ITS CORRELATION WITH RANDOM SPOT URINE PROTEIN-CREATININE RATIO AND 24 HOUR URINE PROTEIN IN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS –A SINGLE CENTRE EXPERIENCE IN MALAYSIA
Authors: C. R. Ng, Y. L. Loh
Journal: Annals of the Rheumatic Diseases (2021)

Background: Lupus nephritis is an important concern among Systemic Lupus Erythematosus (SLE) patients in Asia and its mortality rate was reported to be 6 times higher compared to the general population [1]. Without prompt treatment it can lead to end stage renal failure and affect quality of life. 24 hour urine protein collection has long been used as the gold standard test to assess proteinuria. However due to its cumbersome process random spot urine protein-creatinine ratio is used as an alternative to replace the former in some centres before subjecting patients to renal biopsy. In a study done by Matar HE et al in 2012, he showed that there was a significant correlation between 24 hour urine protein and urine protein creatinine ratio in his 95 subjects [2]. Urinalysis is a semi-quantitative screening tool for early detection of potential kidney disorders. A survey done by Siedner MJ et al on practice preferences among American Rheumatologists in 2005 reported that 64.6% of them preferred to use urinalysis as the primary tool to screen for proteinuria [3]. Objectives: To assess the correlation of urinalysis test with random spot urine protein-creatinine ratio PCR) compared with 24 hour urine protein. Methods: This was a retrospective study. The electronic medical records of all SLE patients seen in the rheumatology clinic of Hospital Sultan Ismail from 1/1/2017 to 31/12/2020 were reviewed. Patients who had urinalysis, urine protein creatinine ratio and 24 hour urine protein tests done were identified. Data on demography, urinalysis, random spot urine protein creatinine ratio and 24 hour urine protein were obtained and analysed. Results: There were a total of 131 patients and 124 were females. The majority were Malays (75/131) followed by the Chinese (45/131),Indians (9/141) and others (2/131). The mean age group for the studied subjects was 34 (13-67). The urinalysis test showed that 34 of them had negative results, 37 of them had urine protein of 1 +, 18 of them had urine protein of 2+ followed by 23 patients with urine protein of 3 + and the rest had urine protein of 4+. The correlation between urinalysis and 24 hour urine protein was strong (r = 0.702), whereas the correlation between urinalysis and urine PCR ratio was stronger (r = 0.797). Conclusion: We conclude that urinalysis correlates well with both random spot urine protein creatinine ratio and 24 hour urine protein and the correlation is stronger with urine PCR. References: [1]Yap DY, Tang CS, Ma MK, Lam MF, Chan TM. Survival analysis and causes of mortality in patients with lupus nephritis. Nephrol Dial Transplant. 2012;27:3248–3254. [PubMed] [2]Matar HE, Peterson P, Sangle S, D’Cruz DP. Correlation of 24-hour urinary protein quantification with spot urine protein: creatinine ratio in lupus nephritis. Lupus 2012 Jul;21(8): 836-9. doi:10.1177/0961203312437438. Epub 2012 Feb 13. [3]Siedner MJ, Christopher-Stine L, Astor BC, Gelber AC, Fine DM. Screening for proteinuria in patients with lupus: a survey of practice preferences among American rheumatologists. J Rheumatol. 2007;34:973–977. [PubMed]. Disclosure of Interests: None declared