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uPCR vs 24h Proteinuria — ESENeph MCQ

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EasyChronic Kidney DiseaseuPCR vs 24h ProteinuriaESENeph

A 42-year-old man with suspected nephrotic syndrome has a 24-hour urine collection showing 4.2 g protein. The lab also reports a spot uPCR of 480 mg/mmol from a morning sample. What is the relationship between these two results?

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Correct answer: E — Spot uPCR (mg/mmol) approximates 24-hour proteinuria (g/day); uPCR 480 mg/mmol ≈ 4.8 g/day, broadly concordant with the 24-hour result

Spot uPCR (mg/mmol) provides a reasonable approximation of 24-hour protein excretion (g/day) – approximately uPCR 100 mg/mmol ≈ 1 g/day (though the conversion is imperfect). KDIGO 2024 recommends using spot uACR or uPCR as the preferred method for proteinuria quantification, as 24-hour collections are cumbersome and frequently inaccurate (incomplete collections). The concordance in this case (uPCR 480 ≈ 4.8 g/day vs 24h collection 4.2 g/day) demonstrates the utility of spot samples.

Reference: KDIGO 2024 – CKD Guideline