24 Hours Protein Creatinine Ratio (PCR)
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Evaluates protein loss in urine normalized to creatinine; used in diagnosing and monitoring kidney disease.
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🧪 24-Hour Urine Protein Creatinine Ratio (PCR)
Feature | Details |
|---|---|
Fasting Required? | ❌ Not required |
Sample Required | 24-hour urine collection (or random spot urine in some protocols) |
Organs Involved | Kidneys (glomeruli and tubules) |
Used For | Detecting proteinuria (excess protein in urine), monitoring kidney disease |
Normal Range | < 150 mg protein/g creatinine (typically); values may vary by lab |
🔬 What Does PCR Measure?
The Protein/Creatinine Ratio (PCR) gives an estimate of how much protein is being lost in the urine over a 24-hour period without needing to measure the total volume of urine — especially helpful when a full 24-hour urine collection isn’t feasible.
- Protein: Should normally be very low in urine. Presence of significant protein = potential kidney damage.
- Creatinine: Produced at a relatively constant rate, used as a reference to normalize protein output.
📌 PCR (mg/g) = Protein (mg/dL) / Creatinine (mg/dL)
📈 Interpretation of PCR Results
PCR Value (mg/g) | Interpretation | Clinical Indication |
|---|---|---|
< 150 | Normal | No significant proteinuria |
150–500 | Microalbuminuria / Mild proteinuria | Early kidney disease, diabetes, HTN |
500–3500 | Moderate proteinuria | Possible glomerulonephritis or CKD |
> 3500 | Nephrotic range proteinuria | Nephrotic syndrome, significant kidney damage |
🩺 Common Clinical Uses
- Diabetic nephropathy monitoring
- Hypertension-related kidney damage
- Lupus nephritis, glomerulonephritis
- Nephrotic syndrome diagnosis
- Follow-up in chronic kidney disease (CKD)
🔗 Recommended Complementary Tests
If PCR is Elevated | Consider These Tests |
|---|---|
Persistent proteinuria | Serum Creatinine, eGFR, BUN |
Suspected glomerular disease | ANA, dsDNA, Complement levels (C3, C4) |
Diabetes or hypertension present | HbA1c, Blood pressure monitoring |
Nephrotic-range proteinuria | Lipid profile, Serum albumin, Urine microscopy |
Suspected multiple myeloma | Urine Bence-Jones protein, Serum protein electrophoresis (SPEP) |
🧾 When to Use 24-hour vs Spot PCR
Test Type | Use Case |
|---|---|
24-hour PCR | Best for accurate quantification in complex renal conditions |
Spot (random) PCR | Good for screening and routine follow-up |
✅ Summary
Test | Purpose | Sample | Fasting | Normal Range |
|---|---|---|---|---|
PCR (Protein/Creatinine Ratio) | Detect and quantify protein loss in urine | 24-hour urine (or spot sample) | No | < 150 mg/g |
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