Detection of Proteinuria in Pregnancy: Comparison of Qualitative Tests for Proteins and Dipsticks with Urinary Protein Creatinine Index

Abstract

Background and Objectives: Excretion of urinary protein increases to 300 mg/d (from up to 150 mg/d) in normal pregnancy. Values above this may be due to disorders that can endanger the patient or her pregnancy. Quantitative analysis of 24-hour urine is considered the gold standard for ascertaining daily protein excretion. Routine laboratory tests performed on spot urine samples indicate protein concentration in the particular sample, and can lead to diagnostic error if urine output is less or more than 1L/d. The Protein Creatinine Index (PCI) shows good correlation with 24-hour protein estimation. However, PCI varies with sex and race. We have correlated the results of qualitative estimation procedures and the dipstick values with protein creatinine index. Material and Methods:We measured protein and creatinine in spot urine samples obtained from 57 pregnant and 80 nonpregnant healthy women of 18-36 years, and calculated PCI. We also tested the samples qualitatively for proteins by routine tests and dipsticks.Results: Normal range of PCI in non-pregnant women, determined by a non-parametric method was 30-150. PCI was increased significantly in pregnancy (maximum increase in the third trimester). Amongst the qualitative tests, heat coagulation test gave the lowest percentage of false positives and a slightly higher percentage of false negatives compared to Heller's nitric acid and sulphosalicylic acid tests, and dipsticks.

IPNA clinical practice recommendations for the diagnosis and management of children with steroid-sensitive nephrotic syndrome

“…The mainstay of disease surveillance lies with regular home monitoring, usually by urine dipstick. In case of non-availability of dipsticks, the heat coagulation test or semi-quantitative testing with sulfosalicyclic acid may be used for detecting urine protein [ 73 – 76 ]. Details of performing the heat coagulation test are available in the supplementary material .…”

Physiologic Changes During Pregnancy and Impact on Small‐Molecule Drugs, Biologic (Monoclonal Antibody) Disposition, and Response

“…While estimated GFR is used in determining renal function in nonpregnant adults and has been used extensively in estimating renal function in pregnant women, 1 study showed that estimated GFR may not be a reliable measure of renal function in pregnant women 11 . Pregnancy causes an increase in proteinuria, with daily maximums of ≈300 mg compared to 150 mg in nonpregnant adults 12 . The renal changes during pregnancy contribute significantly to the clearance and disposition of several drugs.…”

“… 11 Pregnancy causes an increase in proteinuria, with daily maximums of ≈300 mg compared to 150 mg in nonpregnant adults. 12 The renal changes during pregnancy contribute significantly to the clearance and disposition of several drugs. A summary of the renal changes that occur during pregnancy is presented in Table 3 .…”

Skrining Urinalisa pada Ibu Hamil Berdasar Kajian Cross-Sectional

“…Meskipun koleksi rawat inap dan rawat jalan digabungkan, jumlah rata-rata proteinuria pada trimester ketiga pada kehamilan tunggal adalah 204 mg (Osmundson et al, 2014). Penelitian yang dilakukan oleh Saxena et al (2013) dalam deteksi proteinurin pada saat kehamilan menunjukkan kisaran normal Protein Creatinine Index (PCI) pada wanita tidak hamil, ditentukan dengan metode non-parametrik adalah 30-150. PCI meningkat secara signifikan pada kehamilan (peningkatan maksimum pada trimester ketiga).…”