Urine Protein:Creatinine Ratio (UPCR)
Spot urine protein:creatinine ratio estimates 24-hour urinary protein excretion without timed urine collection.
Score interpretation
UPCR <15 mg/mmol. Normal urinary protein excretion (<150 mg/day equivalent).
→ No proteinuria. Routine monitoring as appropriate.
UPCR 15–50 mg/mmol. Microalbuminuria or mild proteinuria.
→ Investigate cause (diabetes, hypertension, early nephropathy). ACEi/ARB in diabetic nephropathy. Repeat testing.
UPCR 50–350 mg/mmol. Significant proteinuria (500–3500 mg/day).
→ Nephrology referral. Renal biopsy consideration. Optimise ACEi/ARB. Blood pressure control <130/80 mmHg.
UPCR >350 mg/mmol (>3.5 g/day equivalent). Nephrotic-range proteinuria.
→ Urgent nephrology referral. Assess for nephrotic syndrome (hypoalbuminaemia, oedema, hyperlipidaemia). Consider immunosuppression after renal biopsy.
Interpretation bands for the UPCR. Apply clinical judgement and local guidance.
References
- KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chronic Kidney Disease. Kidney Int Suppl. 2013;3(1):1-150.
Related
Curated clinical cross-links plus same-class fallbacks.
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- Spontaneous Bacterial Peritonitis (SBP) Diagnosis · Diagnostic
- Modified Alvarado Score (MANTRELS) for Appendicitis · Diagnostic
- New Orleans Head CT Decision Rule · Diagnostic
- MS Phenotype Classification (McDonald / Phenotype) · Diagnostic
- CHALICE Rule for Childhood Head Injury · Diagnostic
- Telitacicept (APRIL/BLyS Dual Inhibitor — SLE/IgA Nephropathy) · TACI-Fc Fusion Protein (Dual APRIL and BLyS Inhibitor)
- Dairy products · Nutritional source (calcium, protein, vitamin D)
- Protein C (Specialist drug) · Recombinant/plasma-derived protein C concentrate
- Respiratory syncytial virus (RSV) vaccine · RSV pre-fusion F protein vaccine
- Tuberculin purified protein derivative · Mycobacterial antigen for delayed-type hypersensitivity testing
- Fluorescein Sodium 2% Eye Drops · Diagnostic ophthalmic dye
- Hyperkalaemia Management · UK Kidney Association Guidelines 2020; NICE CKD Guidelines
- Rhabdomyolysis · Renal Association 2018; UpToDate 2024
- Hypocalcaemia (Adult) · Society for Endocrinology
- SIADH (Endocrine Perspective) · European Hyponatraemia Guidelines 2014
- Hepatorenal Syndrome · EASL 2018; ICA 2015
- Acute Kidney Injury (AKI) · KDIGO 2012 / NICE AKI 2019
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.