EC Neurology

Background: Quantification of proteinuria is central to the management of chronic kidney disease (CKD). The urinary albumin-to-creatinine ratio (ACR) and protein-to-creatinine ratio (PCR), recommended by the KDIGO guidelines, allow their ratio to point towards a glomerular or tubulo-interstitial origin of proteinuria.

Objective: To describe the epidemiological profile of a Moroccan cohort and to evaluate the value of the ACR/PCR ratio in guiding the aetiological work-up.

Methods: Retrospective descriptive and analytical study of 655 adult specimens with simultaneous ACR and PCR determination (June 2023 to June 2026).

Results: Median age was 65 years, with male predominance (sex ratio 1.49). The ACR/PCR ratio discriminated the profiles effectively (ACR area under the curve = 0.87) and increased with CKD severity. Chart review identified glomerular (47.6%), tubulo-interstitial (33.3%) and mixed (19.1%) involvement.

Conclusion: The ACR/PCR ratio is a simple, automatable and non-invasive laboratory tool that helps guide the aetiological work-up of nephropathies.

Keywords: ACR; PCR; Chronic Kidney Disease; KDIGO; Glomerular Nephropathy; Tubulo-Interstitial Nephropathy

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