Evaluation of Spot Urinary Albumin–Creatinine Ratio as Screening Tool in Prediction of Pre-eclampsia in Early Pregnancy

Mishra, Vineet; Goyal, Preeti; Roy, Priyankur; Choudhary, Sumesh; Aggarwal, Rohina; Gandhi, Khushali; Vyas, Bhumika; Hokabaj, Shaheen

doi:10.1007/s13224-016-0950-7

Cited by 12 publications

(14 citation statements)

References 13 publications

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“…11,12 The sensitivity of spot UPCR at the cut-off value of ≥ 35.5 mg/mmol as a screening test to predict preeclampsia in our study was found to be 80% which is comparable to the studies done by Baweja et al, (83.3%), Fatema et al, (80%) and Mishra et al, (87.5%). [11][12][13] In the present study abnormal uterine artery doppler indices (RI > .0.7/PI > 1.4/ presence of diastolic notch) were associated with increased risk of developing preeclampsia in later part of pregnancy. The cut-off value of RI and PI was similar with the study of Sahoo et al 14 Razieh DF et al, found that 23 pregnancies (85.2%) with preeclampsia had RI more than 0.7 and only 4 (14.8%) had RI < 0.7 (p = 0.001).…”

Section: Discussionsupporting

confidence: 50%

Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Modak¹,

Pal²,

Pal³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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Background: Preeclampsia (PE) is heterogeneous disorder. The aim of the study was to observe the role of a spot urinary protein - creatinine ratio (UPCR) and uterine artery doppler velocimetry measured between 20-24 weeks of gestation in prediction of preeclampsia.Methods: Prospective observational study conducted on 120 pregnant mothers with singleton pregnancy between 20-24 weeks of gestational age in two tertiary teaching hospitals in eastern India. A spot urinary protein creatinine ratio (UPCR) was determined in a mid- stream urine sample and estimation of protein was done by immunoturbidimetric micro albumin method and creatinine by modified Jaffe’s method. Doppler velocimetry was also determined at 20-24 weeks of gestation. A notch in uterine artery, unilateral or bilateral; or RI > 0.7 and PI of > 1.45 were considered to have an abnormal result. Women were followed-up and relationship between variables was assessed by Chi- square test.Results: Women who subsequently developed preeclampsia had significantly higher UPCR (median 44.8 mg/mmol) when compared with women of unaffected groups (median 26.6 mg/mmol). The optimum spot urinary UPCR to predict preeclampsia was 35.5 mg/mmol and the cut-off value >35.5 mg/mmol had a test sensitivity (80%), specificity (94.06%), PPV (66.76%) and NPV (96.94%).The area under curve (AUC) of spot UPCR in ROC curve was 0.949 (95% CI,0.891 - 1.000). For predicting preeclampsia, the mean uterine artery RI had to be >0.7 having sensitivity (60%), specificity (97.03%), PPV (75%) and NPV (94.23%). The area under curve (AUC) was 0.856 (95% CI, 0.742 - 0.971).Conclusions: Second trimester UA doppler is a useful screening test for prediction of preeclampsia. This test works best when combined with a spot UPCR and accuracy of both the methods for prediction of preeclampsia was 92.24%.

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Section: Discussionsupporting

confidence: 50%

Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Modak¹,

Pal²,

Pal³

et al. 2020

Int J Reprod Contracept Obstet Gynecol

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“…The single criteria for inclusion in the study were the presence of diagnosed SLE according to the American College of Rheumatology 1997 criteria. 7 The exclusion criteria included the presence of any kidney disease with other etiology like diabetes, pregnant women, and thyroid disease.…”

Section: Introductionmentioning

confidence: 99%

Clinical Significance of Cystatin C, Creatinine, and Blood Urea in Lupus Nephritis Patients with Systemic Lupus Erythematosus: A South Indian Case–Control Study

Yadav¹,

Rani²,

Suleman³

et al. 2021

Indian Journal of Medical Biochemistry

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Lupus nephritis (LN) develops as a result of immunological abnormalities. The pathogenesis of LN is a complex process, involving the deposition of autoantibodies in the glomerulus. The glomerular filtration rate (GFR) is widely accepted as the best overall measure of kidney function, enabling a statement of the complex functions of the kidney in a single numeric expression. The endogenous marker of GFR commonly employed is creatinine, but it does not complete the requirements of an ideal marker because apart from being subjected to tubular secretion it is also influenced by the muscle mass and gender of the patient. Cystatin C is a protein produced by all nucleated cells in the body, freely filtered by glomerulus; neither returned to the bloodstream nor secreted by the renal tubules and also is not influenced by gender or muscle mass. The above features make it a better marker of renal function than creatinine. The medical therapy for LN depends on the severity of the disease. Finding reliable biomarkers for LN will help to evaluate disease activity, identify patients at risk for kidney damage, and facilitate early diagnosis and intervention to improve favorable outcomes.

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“…This value was significantly higher in pre-eclamptic patients (p<0.001). According to our reference study 14 , the cutoff value for urinary albumin to creatinine ratio was taken as 35.5 mg/mmol. (Table-I) Over all, the test was positive in forty seven (23.5%) patients and negative in the remaining one hundred and fifty three (76.5%) patients ( Table-II).…”

Section: Resultsmentioning

confidence: 99%

Urinary Albumin to Creatinine Ratio as a Predictor of Preclampsia Among Pregnant Women at a Tertiary Care Hospital

2019

JMPB

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Objective:To determine the diagnostic accuracy of point urinary albumin to creatinine ratio at 20 +0 and 28 +0 weeks of gestation for predicting the possibility of developing pre-eclampsia, late in pregnancy. Study Design:A prospective cross sectional study. Place and Duration of Study: Gynecology Outpatients DepartmentMethodology: Age, weight, gravidity and Body Mass index was documented for total 250 patients included for study. Patients were divided on the basis of development of pre-eclampsia and their mean Albumin to creatinine ratio was compared by applying Student's t-test considering p≤0.05 statistically significant. Test positive and test negative patients were noted. The association of urinary albumin to creatinine ratio with pre-eclampsia was calculated. SPSS v.23 software was used to analyze the data. Results:Mean urinary albumin to creatinine ratio was 22.77±12.42 mg/mmol in normotensive women and 46.87±15.13 mg/mmol in pre-eclamptic women which was significantly higher in pre-eclamptic patients (p<0.001). The sensitivity of point urinary albumin to creatinine ratio at a cutoff value of 35.5mg/mmol is 73.91%; the specificity is 91.56%; the positive predictive value (PPV) is 72.34%; and negative predictive is 92.16%. Conclusion:Our study concluded that solitary point urinary albumin creatinine ratio values equal to or higher than 35.5mg/mmol, when quantified early during the second trimester had a higher specificity than the sensitivity and it can be safely used to rule out the possibility of developing pre-eclampsia, late in pregnancy.

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Evaluation of Spot Urinary Albumin–Creatinine Ratio as Screening Tool in Prediction of Pre-eclampsia in Early Pregnancy

Cited by 12 publications

References 13 publications

Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Prediction of preeclampsia by a combination of maternal spot urinary protein-creatinine ratio and uterine artery doppler

Clinical Significance of Cystatin C, Creatinine, and Blood Urea in Lupus Nephritis Patients with Systemic Lupus Erythematosus: A South Indian Case–Control Study

Urinary Albumin to Creatinine Ratio as a Predictor of Preclampsia Among Pregnant Women at a Tertiary Care Hospital

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