The Urine Protein/Creatinine Ratio as a Tool for Evaluating Proteinuria in the Risk Assessment of Severe Dengue in a Tertiary Care Hospital

Background: Dengue fever, caused by the dengue virus and transmitted primarily by Aedes mosquitoes, can lead to severe complications such as Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS). Early identification of patients at risk for severe disease is crucial for effective management.  Objective: This study aims to assess the utility of the urine spot protein/creatinine ratio (PCR) as a prognostic tool for predicting the risk of developing DHF and DSS in patients with dengue fever.  Methods: A prospective study was conducted on 100 adult patients diagnosed with dengue fever at Katuri Medical College and Hospital from September 2022 to February 2024. Patients were evaluated for urine spot PCR levels, and clinical outcomes were monitored to determine the incidence of DHF and DSS.  Results: The study found that 25% of patients exhibited proteinuria levels greater than 560 mg/g, with a significant correlation to the development of DHF and DSS. The sensitivity of urine spot PCR for predicting severe dengue was 68.7%, while specificity was 95.5%. The positive predictive value was 88%, and the negative predictive value was 86.6%.  Conclusion: The urine spot protein/creatinine ratio is a valuable prognostic indicator for identifying patients at risk of developing severe dengue complications. Implementing this simple and non-invasive test in clinical practice can enhance early risk stratification and improve patient management in dengue fever cases. Further research is recommended to validate these findings in larger cohorts.