Urine Protein Creatinine Ratio

The test of choice for proteinuria

The UPC ratio provides an accurate and fully quantitative assessment of proteinuria unlike the urine dipstick which is less sensitive and specific for the detection of  protein in urine.

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A case study

Muriel

9 year old female cat
Muriel presented to the hospital with a history of mild PU/PD, intermittent vomiting which sometimes contains hair, and weight loss…
Patient Nine-year-old female cat
Presenting Complaints Mild PU/PD, intermittent vomiting sometimes containing hair, weight loss
Physical Exam Moderate dental tartar, unkempt coat, dirty tail (signs of diarrhoea), tachycardia, dry mucous membranes, light skin fold (estimated dehydration: 5% to 7%) and palpable thyroid nodule.

 

Why UPC?

The UPC Ratio is a simple test that measures how much protein is being lost through the kidneys, and determines if the loss poses a health risk for the pet.

Proteinuria is an important concern given its correlation with poor patient outcome. The UPC Ratio has shown a significant correlation with the morbidity of the patient—the higher the UPC ratio value, the worse the prognosis.

The UPC Ratio is the best test available for:

  • Detecting proteinuria and measuring persistence and magnitude
  • Guiding clinical decisions and monitoring response to therapy
 

UPC Algorithm

Once an animal has been diagnosed with CKD and staged according to IRIS guidelines, the next step is to substage the dog or cat based on proteinuria and hypertension.


* An inactive sediment is free of bacteria, WBC and RBC.

 

Understanding UPC

The UPC Ratio normalizes urine protein levels for variability in urine concentration.
A CKD patient with good urine concentrating ability:



A CKD patient with loss of concentrating urine ability:


Jonathan Elliott

Vice-Principal (Research and Innovation)
Royal Veterinary College, University of London

MA, Vet MB, PhD, Cert SAC,
Dip ECVPT, MRCVS

"The degree of proteinuria when the animal is first diagnosed with renal disease is helpful in predicting survival time, according to our studies. It’s a gradation; the lower the protein in the urine, the longer the cat is going to survive.”

 

Synopses from the scientific literature

2004 ACVIM Forum Consensus Statement   Relation of Survival Time and Urinary Protein Excretion in Cats with Renal Failure and/or Hypertension   Proteinuria and Renal Disease – A roundtable discussion
A great deal of attention has been given to the role of proteinuria in the diagnosis of renal disease.   The degree of proteinuria is predictive of the survival times in cats with CRF.   This Roundtable is a discussion by the world’s leading experts on renal disease and practitioners discussing kidney disease and proteinuria.
The leading veterinary experts in Nephrology developed the ACVIM Forum Consensus Statement (Small Animal) on July 28, 2004: “Assessment and Management of Proteinuria in Dogs and Cats”. This 18 page document highlights the most recent research on urine protein and reviews the definition and classification of proteinuria, how it is best to detected and assessed, what the implications are of increased persistent renal proteinuria, when and how to test for proteinuria and how the veterinarian should respond clinically to a finding of proteinuria.   In addition to monitoring proteinuria and evaluating the response to therapy, the UPC ratio can be used to determine the approximate survival time of the cat. The higher the level of proteinuria, the shorter the survival time for a given feline patient.   It includes useful information about the prevalence of kidney disease in dogs and cats as well as practical information about diagnosing and treating and monitoring kidney disease in the canine and feline patient.
Download Full PDF   Download Full PDF   Download Full PDF

Identify and Monitor proteinuria during the patient visit

IDEXX Urine P:C (Urine Protein Creatinine) Ratio test available for use on
all IDEXX in-house chemistry analysers.

  • Quantify proteinuria for substaging of chronic kidney disease
  • Results in as few as 8 minutes allows for immediate treatment
  • See all of your patients diagnostic information on one report
    to easily monitor and evaluate treatment
  • Accurate, convenient, and easy to run on
    your IDEXX Chemistry Analyser