Determination of and correlation between urine protein excretion and urine protein-to-creatinine ratio values during a 24-hour period in healthy horses and ponies

Benjamin Uberti Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907.

Search for other papers by Benjamin Uberti in
Current site
Google Scholar
PubMed
Close
 DVM
,
D. Bernard Eberle School of Veterinary Medicine, Purdue University, West Lafayette, IN 47907.

Search for other papers by D. Bernard Eberle in
Current site
Google Scholar
PubMed
Close
 BS
,
Barrak M. Pressler Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907.

Search for other papers by Barrak M. Pressler in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
,
George E. Moore Department of Comparative Pathobiology, Purdue University, West Lafayette, IN 47907.

Search for other papers by George E. Moore in
Current site
Google Scholar
PubMed
Close
 DVM, PhD
, and
Janice E. Sojka Department of Veterinary Clinical Sciences, Purdue University, West Lafayette, IN 47907.

Search for other papers by Janice E. Sojka in
Current site
Google Scholar
PubMed
Close
 VMD, MS

Abstract

Objective—To determine whether urine protein-to-creatinine (UP:C) ratio assessment provides an estimate of urine protein excretion (UPE) over a 24-hour period in horses and ponies, establish a preliminary UP:C ratio reference range, and determine UP:C ratio variation over time in healthy equids.

Animals—11 female horses and 6 female ponies.

Procedures—Urine was collected from all equids at 4-hour intervals for 24 hours. Total 24-hour UPE (mg of protein/kg of body weight) and UP:C ratio were determined; these variables were also assessed in aliquots of urine collected at 4-hour intervals. On 2 additional days, urine samples were also obtained from 6 horses (1 sample/horse/d) to determine day-to-day variation in UP:C ratio. Correlation between 4-hour or 24-hour UPE and UP:C ratio values was assessed. Reference ranges for 24-hour UPE, 24-hour UP:C ratio, and 4-hour UP:C ratios were calculated as central 95th percentiles of observed values.

Results—Mean 24-hour UPE (4.28 ± 2.99 mg/kg) and 24-hour UP:C ratio (0.0 to 0.37) had excellent correlation (R = 0.826; P < 0.001) in both horses and ponies; analysis of 4-hour data also revealed good correlation (R = 0.782; P < 0.001) with these variables. Calculated UPE and UP:C ratio reference ranges were similar to established ranges in other species. Day-to-day variability in UP:C ratio was minimal, and all results were within the reference range calculated by use of the 24-hour urine samples.

Conclusions and Clinical Relevance—Assessment of the UP:C ratio appears to be a reliable method for estimating 24-hour UPE in horses and ponies.

Abstract

Objective—To determine whether urine protein-to-creatinine (UP:C) ratio assessment provides an estimate of urine protein excretion (UPE) over a 24-hour period in horses and ponies, establish a preliminary UP:C ratio reference range, and determine UP:C ratio variation over time in healthy equids.

Animals—11 female horses and 6 female ponies.

Procedures—Urine was collected from all equids at 4-hour intervals for 24 hours. Total 24-hour UPE (mg of protein/kg of body weight) and UP:C ratio were determined; these variables were also assessed in aliquots of urine collected at 4-hour intervals. On 2 additional days, urine samples were also obtained from 6 horses (1 sample/horse/d) to determine day-to-day variation in UP:C ratio. Correlation between 4-hour or 24-hour UPE and UP:C ratio values was assessed. Reference ranges for 24-hour UPE, 24-hour UP:C ratio, and 4-hour UP:C ratios were calculated as central 95th percentiles of observed values.

Results—Mean 24-hour UPE (4.28 ± 2.99 mg/kg) and 24-hour UP:C ratio (0.0 to 0.37) had excellent correlation (R = 0.826; P < 0.001) in both horses and ponies; analysis of 4-hour data also revealed good correlation (R = 0.782; P < 0.001) with these variables. Calculated UPE and UP:C ratio reference ranges were similar to established ranges in other species. Day-to-day variability in UP:C ratio was minimal, and all results were within the reference range calculated by use of the 24-hour urine samples.

Conclusions and Clinical Relevance—Assessment of the UP:C ratio appears to be a reliable method for estimating 24-hour UPE in horses and ponies.

Contributor Notes

Dr. Uberti's present address is Doña Pilar Embriones, Lincoln, Buenos Aires, Argentina.

Presented in abstract form at the 26th American College of Veterinary Internal Medicine Forum, San Antonio, Tex, June 2008.

Supported by Indiana Racing Commission Funds.

Address correspondence to Dr. Uberti (buberti@gmail.com).
  • 1.

    Lees GE, Brown SA, Elliott J, et al. Assessment and management of proteinuria in dogs and cats: 2004 ACVIM Forum Consensus Statement (small animal). J Vet Intern Med 2005;19:377385.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 2.

    de Zeeuw D, Remuzzi G, Parving HH, et al. Proteinuria, a target for renoprotection in patients with type 2 diabetic nephropathy: lessons from RENAAL. Kidney Int 2004;65:23092320.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 3.

    Finco DR, Brown SA, Brown CA, et al. Progression of chronic renal disease in the dog. J Vet Intern Med 1999;13:516528.

  • 4.

    Jacob F, Polzin DJ, Osborne CA, et al. Evaluation of the association between initial proteinuria and morbidity rate or death in dogs with naturally occurring chronic renal failure. J Am Vet Med Assoc 2005;226:393400.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 5.

    Danziger J. Importance of low-grade albuminuria. Mayo Clin Proc 2008;83:806812.

  • 6.

    Gerstein HC, Mann JF, Yi Q, et al. Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals. JAMA 2001;286:421426.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 7.

    Syme HM, Markwell PJ, Pfeiffer D, et al. Survival of cats with naturally occurring chronic renal failure is related to severity of proteinuria. J Vet Intern Med 2006;20:528535.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 8.

    Whittemore JC, Gill VL, Jensen WA, et al. Evaluation of the association between microalbuminuria and the urine albumin-creatinine ratio and systemic disease in dogs. J Am Vet Med Assoc 2006;229:958963.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 9.

    Whittemore JC, Miyoshi Z, Jensen WA, et al. Association of microalbuminuria and the urine albumin-to-creatinine ratio with systemic disease in cats. J Am Vet Med Assoc 2007;230:11651169.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 10.

    Ruggenenti P, Gaspari F, Perna A, et al. Cross sectional longitudinal study of spot morning urine protein:creatinine ratio, 24 hour urine protein excretion rate, glomerular filtration rate, and end stage renal failure in chronic renal disease in patients without diabetes (Erratum published in BMJ 1998;317:1491). BMJ 1998;316:504509.

    • Search Google Scholar
    • Export Citation
  • 11.

    Grauer GF, Thomas CB, Eicker SW. Estimation of quantitative proteinuria in the dog, using the urine protein-to-creatinine ratio from a random, voided sample. Am J Vet Res 1985;46:21162119.

    • Search Google Scholar
    • Export Citation
  • 12.

    Ginsberg JM, Chang BS, Matarese RA, et al. Use of single voided urine samples to estimate quantitative proteinuria. N Engl J Med 1983;309:15431546.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 13.

    Lemann J Jr, Doumas BT. Proteinuria in health and disease assessed by measuring the urinary protein/creatinine ratio. Clin Chem 1987;33:297299.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 14.

    Schwab SJ, Christensen RL, Dougherty K, et al. Quantitation of proteinuria by the use of protein-to-creatinine ratios in single urine samples. Arch Intern Med 1987;147:943944.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 15.

    Adams LG, Polzin DJ, Osborne CA, et al. Correlation of urine protein/creatinine ratio and twenty-four-hour urinary protein excretion in normal cats and cats with surgically induced chronic renal failure. J Vet Intern Med 1992;6:3640.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 16.

    Kohn CW, Strasser SL. 24-hour renal clearance and excretion of endogenous substances in the mare. Am J Vet Res 1986;47:13321337.

  • 17.

    Asplin KE, Sillence MN, Pollitt CC, et al. Induction of laminitis by prolonged hyperinsulinaemia in clinically normal ponies. Vet J 2007;174:530535.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 18.

    Schott HC II, Hodgson DR, Bayly WM. Haematuria, pigmenturia and proteinuria in exercising horses. Equine Vet J 1995;27:6772.

  • 19.

    White JV, Olivier NB, Reimann K, et al. Use of protein-tocreatinine ratio in a single urine specimen for quantitative estimation of canine proteinuria. J Am Vet Med Assoc 1984;185:882885.

    • Search Google Scholar
    • Export Citation
  • 20.

    Wingo CS, Clapp WL. Proteinuria: potential causes and approach to evaluation. Am J Med Sci 2000;320:188194.

  • 21.

    Martin-Du Pan RC, Benoit R, Girardier L. The role of body position and gravity in the symptoms and treatment of various medical diseases. Swiss Med Wkly 2004;134:543551.

    • Search Google Scholar
    • Export Citation
  • 22.

    Newman DJ, Pugia MJ, Lott JA, et al. Urinary protein and albumin excretion corrected by creatinine and specific gravity. Clin Chim Acta 2000;294:139155.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 23.

    Gary AT, Cohn LA, Kerl ME, et al. The effects of exercise on urinary albumin excretion in dogs. J Vet Intern Med 2004;18:5255.

  • 24.

    Wilson ME. Examination of the urinary tract in the horse. Vet Clin North Am Equine Pract 2007;23:563575.

  • 25.

    Pressler BM, Vaden SL, Jensen WA, et al. Detection of canine microalbuminuria using semiquantitative test strips designed for use with human urine. Vet Clin Pathol 2002;31:5660.

    • Crossref
    • Search Google Scholar
    • Export Citation
  • 26.

    Frank N. Insulin resistance in horses, in Proceedings. 52nd Annu Conv Am Assoc Equine Pract 2006;5154.

  • 27.

    Treiber KH, Kronfeld DS, Geor RJ. Insulin resistance in equids: possible role in laminitis. J Nutr 2006;136 (suppl 7):2094S2098S.

Advertisement