Volume 76, Issue 12, Pages (December 2009)

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Spot urine protein/creatinine ratios are unreliable estimates of 24 h proteinuria in most systemic lupus erythematosus nephritis flares D.J. Birmingham,
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Volume 76, Issue 12, Pages 1284-1288 (December 2009) A prospective study of protein excretion using short-interval timed urine collections in patients with lupus nephritis  Derek M. Fine, Martina Ziegenbein, Michelle Petri, Ernest C. Han, Alison M. McKinley, Jerry W. Chellini, Haikady N. Nagaraja, Kathryn A. Carson, Brad H. Rovin  Kidney International  Volume 76, Issue 12, Pages 1284-1288 (December 2009) DOI: 10.1038/ki.2009.344 Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 1 Collection timeline for interval collections. Spot 0 (SP0) was first morning urine and spot 2 (SP24) was obtained after the 24-h urine collection was completed. Note that for Hopkins lupus cohort (HLC), SP24 was obtained as the second morning void and for Ohio SLE Study (OSS), as a random spot collection. SLE, systemic lupus erythematosus. Kidney International 2009 76, 1284-1288DOI: (10.1038/ki.2009.344) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 2 Diurnal variation of protein excretion. Interval protein/creatinine (P/C) ratios were divided by their corresponding 24-h P/C ratios for the indicated intervals. SP0 represents the first morning void. The middle bar represents the mean ratio, and the top and bottom bars represent ±2 standard errors of the mean. *P<0.001 versus 18–24-h interval. Kidney International 2009 76, 1284-1288DOI: (10.1038/ki.2009.344) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 3 Variability of interval protein/creatinine (P/C) ratio declines as the duration of the interval approaches 24 h. Box- and-whisker plots of individual interval P/C ratios divided by their corresponding 24-h P/C ratio. Boxes represent the interquartile range. Whisker lengths represent up to 1.5 times the interquartile range. Outliers beyond the whiskers are shown with open circles. Kidney International 2009 76, 1284-1288DOI: (10.1038/ki.2009.344) Copyright © 2009 International Society of Nephrology Terms and Conditions

Figure 4 Correlation of 6- and 12-h protein/creatinine (P/C) ratio with 24-h P/C ratio. The dashed line represents the line of perfect concordance (45° line); the solid line is the best-fit regression. Kidney International 2009 76, 1284-1288DOI: (10.1038/ki.2009.344) Copyright © 2009 International Society of Nephrology Terms and Conditions