Protein Creatinine Index: An Alternative for Screening Nephropathy in Hypertensives

Abstract

Introduction: The 24 hour urinary protein estimation is the gold standard for detecting proteinuria and nephropathy in hypertensives. But, it’s a time-consuming and inconvenient process. Aim: To analyse the utility of urinary Protein Creatinine Index (PCI) as an alternative approach to predict nephropathy in hypertensives. Materials and Methods: Urinary PCI and 24 hour urinary protein was estimated in 300 hypertensive and 100 control subjects and various diagnostic parameters of urinary PCI, at different cut offs, was assessed using Receiver Operating Characteristic (ROC) curve. The statistical data was analysed using SPSS version 20.0. Results: At cut off 1200, urinary PCI predicts nephropathy with 81.6% sensitivity, 78.5% specificity, 79.52% accuracy and Youden’s index of 0.60, and can be considered as a reasonable diagnostic alternative. Similarly, at cut off 300 and 200, urinary PCI can be used to predict proteinuria >300 mg and >150 mg. At cut off 800, urinary PCI can prognosticate nephropathy with 95.3% sensitivity, 96.33% negative predictive rate and negative likelihood ratio of 0.08. Conclusion: The PCI can diagnose nephropathy and proteinuria, in hypertensives, with good accuracy and can be used as an alternative for 24 hour urinary protein estimation. At the very least, urinary PCI (cut off 800) can be safely used as a screening tool for predicting nephropathy in hypertensives.

Keywords

• hypertension
• hypertensive nephropathy
• kidney disease
• poteinuria