I have two patients who routinely have significantly lower spot protein to creatinine ratios as compared to 24-hour urine for protein.
The urine electropheresis shows non-specific proteinuria.
- The first patient is an obese young African American woman with WHO type V lupus nephritis.
- The other patient is a thin young Caucasian woman with secondary FSGS due to chronic reflux. Her most recent PCR is 1.7, and her 24-hour urine from one week prior is 4.9 g.
Any ideas? What am I missing?