Urine ACR (albumin creatinine ratio) and PCR (protein creatinine ratio); which one is a better predictor of chronic kidney disease? Some research shows UACR as limited to diabetes mellitus and urine PCR for other kidney diseases? Is there any difference between urine ACR and PCR for screening proteinuria and for prognosis of chronic kidney disease?
Indeed, despite the lack of accuracy of total proteins determination in the urine when their concentration is low (many interferences) and their lack of sensitivity in the detection of low MW proteins and free light chains, it is better use total proteins to detect tubulopathies and overload proteinuria (monoclonal immunoglobulin) .The determination of urinary albumin is more reliable but controls only the evolution of this protein and not those of the other proteins of higher MW. Their concentration will increase with the progression of renal insufficiency
If you suspect a tubular damage, it´s necesary do PCR (Non steroid antiinflamatory use, or tubular toxic drugs users, etc) The relation by albumin and protein (or globulins) may be interesting to differenciate between tubular or glomerular damage.
in diabetic (child or adults) ACR is recomended. In other population with HTA risk, too.