Best method of estimation of amount of proteinuria in a child with nephrotic syndrome is –
Correct Answer: 24 hr urine for protein and creatinine
Description: Ans. is 'b' i.e., 24 hr urine for protein and creatinine Methods Available to Test for ProteinuriaMethodIndicationsNormal RangeCommentsDipstick testingRoutine screening for proteinuria performed in the officeNegative of trace in a concentrated urine specimen (specific gravity: > 1.020)False-positive test can occur if urine is very alkaline (pH > 8.0) or very concentrated (specific gravity: > 1.025)24hr urine for protein and creatinine* excretionQuantitation of proteinuria (as well as creatinine clearances)<100 mg/m2/24hr or < 150 mg/24 hr in a documented 24 hr collectionMore accurate than spot urine analysis: inconvenient for patient; limited use in pediatric practice.Spot urine for protein/ creatinine ratio-preferably on first morning urine specimen.Semiquantitative assessment of proteinuria.< 0.2 mg protein/mg creatinine in children > 2yr old.< 0.5 mg protein/mg creatinine in those 6-24 mo old.Simplest method to quantitate proteinuria: less accurate than measuring 24hr proteinuria.MicroalbuminuriaAssess risk of progressive glomerulopathy in patients with diabetes mellitus.< 30mg urine albumin per gram of creatinine on first morning urine.Therapy should be intensified in diabetics with microablbuminuria.
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