Bhimisetti Srinivasa Chakravarthy, Surath Prathima Devi
BACKGROUND Nephrotic syndrome is a common renal disease in 2-6-year-old children characterised by proteinuria, hypoalbuminemia, oedema and hypercholesterolemia. Incidence is 2-3 /1 lakh children per year. Without treatment, nephrotic syndrome in children is associated with significant morbidity and mortality. Aim of the study is to evaluate the usefulness of urine protein/urine creatinine ratio of (UP/UC) in a random and reliable test for the quantification of proteinuria. MATERIALS AND METHODS This is a prospective case control study for a period of one year i.e., from 1st July 2013 to 30th June 2014 carried out in the paediatric wards of King George Hospital, Visakhapatnam, Andhra Pradesh. A case group of 40 children suffering from nephrotic syndrome and a control group of 40 children with proteinuria due to causes other than nephrotic syndrome who fulfilled the inclusion criteria were included in the study. RESULTS A case group of 40 children between the ages of 2-12 years who were admitted with nephrotic syndrome during the study period. Males were 24(60%) and 16(40%) females. 24(60%) children presented with first episode and 16(40%) children with relapse at the time of admission. All cases presented with anasarca. 21(52.5%) children also had scrotal oedema. Oliguria was present in 39(97.5%) cases and UTI in 22 (55%) children. Regarding lab investigations, urine albumin was found to be 4+ in 36 children. Mean values of serum creatine was 0.603 mg//dl. Urine spot protein to urine creatine ratio was 6.16 in study group, whereas it was 1.01 in control group and the p value was statistically significant (0.0001). Applying tests of significance and kappa statistics, the UP/UC test in comparison with 24- hour urine protein ratio values were found to have a sensitivity of 95%, positive predictive value of 95%, specificity of 95%, positive predictive value of 95% and correlation coefficient r=0.802 and p 3 with normal renal function represents nephrotic range proteinuria.
