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What is Protein To Creatinine Ratio Test?

Protein to creatinine (P/C) test is used to estimate the protein in your urine or proteinuria quantitatively. It helps to diagnose and estimate the course of kidney disease. It also helps to assess the progression and effectiveness of the treatment. The standard gold method of measuring proteinuria is measuring the amount of protein in the urine sample collected in 24 hours. This timed urine collection in 24 hours shows the fluctuations in the daily evaluation of protein; however, this method is time-consuming and disturbing for the patient. Therefore an alternative fast and simple method is developed by spot estimation of protein to creatinine ratio and assessing the amount of protein in the urine, considering a constant amount of creatinine is eliminated through urine in a day.

 

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      Frequently Asked Questions:

      What are the conditions associated with an increased P/C ratio?

      The increased P/C ratio is associated with nephrotic syndrome, immunological kidney diseases, preeclampsia, gestational diabetes, infections, and multiple myeloma.

      Does the P/C ratio show elevated values in healthy individuals?

      P/C ratio may be mildly and temporarily elevated in situations like pregnancy, increased muscular exercise, emotional stress diet and cold exposure.

      What is the normal reference range of the P/C ratio?

      Although the P/C ratio differs from lab to lab in 2012 National kidney foundation of the USA has set a certain limit for the P/C ratio, which is given below as: 

      • normal to mildly increased -<0.15
      • moderately increased -0.15 - 0.50
      • severely increased - >0.50

      What is the normal value of protein eliminated through urine per day?

      A healthy individual eliminates less than 150 mg of protein/day and 30 mg of albumin typically.

      What are the limitations of the P/C ratio test?

      The P/C ratio test does not show day to day variability and fluctuations of protein in urea. It also varies based on ethnicity and muscle mass. The test can also show overestimated or underestimated values.

      What are the specimens collected for the P/C ratio test?

        A spot or random urine sample is collected in a container at any time and is used to test your P/ C ratio.

      Why is the P/C ratio test preferable to the 24 hours protein in urine test?

       The P/C test measures the amount of protein in a spot /random urine sample along with creatinine, which is a byproduct of muscle metabolism and considered to be eliminated in urine at a constant rate. Hence, it is more convenient for the patient and laboratory personnel to refrain from collecting 24 hours urine samples.

      What are the preparations done before taking a P/C ratio test?

      No necessary preparations are required, follow the instructions given by your healthcare provider. 

      How is the P/C test done at the laboratory?

      A semiquantitative dipstick is used to analyse the amount of protein in a random urine sample. Home-based dipsticks are also currently available in the market, which helps the patient to perform the test at home. 

      When should you get tested for the P/C test ratio?

       P/C test is performed as a part of routine urinalysis to diagnose conditions that cause protein in urine and monitor the progression of disease and effectiveness of the treatment.

      Is there any risk associated with doing a P/C test?

      No, there is no potential risk associated as it involves only the collection of urine samples which is a non-invasive procedure. 

       

      References:

      1. Kamińska J, Dymicka-Piekarska V, Tomaszewska J, Matowicka-Karna J, Koper-Lenkiewicz OM. Diagnostic utility of protein to creatinine ratio (P/C ratio) in spot urine samples within routine clinical practice. Crit Rev Clin Lab Sci. 2020 Aug;57(5):345-364.
      2. Haider MZ, Aslam A. Proteinuria. [Updated 2021 Oct 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.

       

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