Protein/creatine ratio in random urine specimens for quantitation of proteinuria in preeclampsia

Oe, Jaschevatzky; Rosenberg, RP; Shalit, A; Zonder, H; Grünstein, S

doi:10.1016/0020-7292(91)90550-o

Cited by 25 publications

(27 citation statements)

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“…Of these, 12 subjects had significant proteinuria at ,20 weeks of gestation and were excluded from the final analysis. Causes of proteinuria in these 12 samples were diabetic nephropathy (6 with type 1 diabetes; 2 with type 2 diabetes) and primary renal disease (4). Seven of the 12 excluded also had chronic hypertension due to diabetes or renal disease.…”

Section: Resultsmentioning

confidence: 99%

A practical approach to using spot urine protein/creatinine ratios for assessing proteinuria in pregnancy

Marnoch¹,

Larson²,

Weitzen

et al. 2008

Obstet Med

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SummaryObjective: The aim of this study is to assess the diagnostic accuracy of the spot urine protein/creatinine ratio compared with the 24-hour urine protein in pregnancy. Study Design: In this prospective cohort study of inpatient pregnant women, the protein/creatinine ratio and dipstick protein were assessed from a single urine sample collected at the start of the 24-hour urine. Both tests were compared with the 24-hour urine protein for correlation and test characteristics. Results: In the 196 specimens analysed, we found a strong correlation between the spot urine protein/creatinine ratio and 24-hour urine protein (r 2 ¼ 0.78, P , 0.01). A protein/creatinine ratio ,0.1 ruled out significant proteinuria (!300 mg/day) with sensitivity and negative predictive value 100%. A protein/creatinine ratio !0.4 detected significant proteinuria (specificity and positive predictive value of 100%). A protein/creatinine ratio !4.6 had a specificity and positive predictive value of 100% for detecting severe proteinuria (!5000 mg/day). Urine dipsticks correlated poorly with the 24-hour urine protein (r 2 ¼ 0.40, P ¼ 0.826). Nineteen percent of dipsticks reading nil or trace were false-negative results. Conclusion:The spot urine protein/creatinine ratio correlated well with the 24-hour urine protein and performed better than the urine dipsticks. Significant proteinuria in pregnancy was excluded if the protein/creatinine ratio was ,0.1 and identified when it was !0.4.

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Section: Resultsmentioning

confidence: 99%

A practical approach to using spot urine protein/creatinine ratios for assessing proteinuria in pregnancy

Marnoch¹,

Larson²,

Weitzen

et al. 2008

Obstet Med

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“…[10][11][12][13][14]16,17 All studies collected the random sample during the daytime and avoided the first void, a potential source of error. 7 Otherwise, random samples could be collected before the 24-hour sample, 13,[15][16][17]19 after the 24-hour sample [10][11][12] or either. 21 To obtain accurate contemporaneous correlation and to avoid the confounding of possible disease progression, we and others 14 felt that sampling during the collection was more valid.…”

Section: Discussionmentioning

confidence: 99%

“…9 Several previous studies have also shown a strong linear correlation between random urinary PCR or ACR and 24-hour urine protein measurement in both healthy and hypertensive pregnant women. [10][11][12][13][14][15][16][17] Other studies have yielded conflicting results, with poor correlation between the amount of protein in a 24-hour collection and PCR or ACR. [18][19][20] The correlation has also been found to be lower when the protein excretion is more than 1-2 g per 24-hour period.…”

Section: Introductionmentioning

confidence: 99%

“…[18][19][20] The correlation has also been found to be lower when the protein excretion is more than 1-2 g per 24-hour period. 10,11 Most previous studies have had small number of subjects (less than 30), have contained heterogeneous groups or have failed to correct for important confounders. [10][11][12][13][14][15][16][17][18][19]21 The aims of this study were 1) to evaluate the correlation between albuminuria measured as ACR and amount of albumin in 24-hour urine samples in women with pre-eclampsia with significant albuminuria, 2) to study the influence of potential confounders on this correlation and 3) to assess the variability of ACR in single urine samples during a 24-hour period.…”

Section: Introductionmentioning

confidence: 99%

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Random albumin/creatinine ratio for quantification of proteinuria in manifest pre‐eclampsia

Wikström

Larsson

et al. 2006

BJOG

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Objective 1) To assess the correlation between urine albumin/ creatinine ratio (ACR) and 24-hour urine albumin excretion in women with pre-eclampsia, 2) to study the influence of potential confounders on this correlation and 3) to assess the variability of ACR between voids during a 24-hour period.Design Prospective study.Setting Fetal maternity ward, university hospital.Population Women with pre-eclampsia scheduled for quantitative albumin measurement with a 24-hour urine collection.Methods Random urine samples were obtained for analysis of ACRs during the time of 24-hour urine collections in 31 women. ACRs were also measured from the complete 24-hour collections. In five additional women, serial urine samples were obtained during the 24-hour collection.Main outcome measures Correlation between ACRs and albumin amount in 24-hour urine samples. Variability of the ACRs during a 24-hour collection.Results The random ACR was poorly correlated to 24-hour excretion of urine albumin (R 2 = 0.42). Adjustment for maternal age and nifedipine medication significantly (P = 0.044 and P = 0.023, respectively) improved the correlation (R 2 = 0.60). The mean variability (highest/lowest) of ACR during a 24-hour period was 222%. The ACR from the 24-hour collection had an excellent correlation to 24-hour excretion of urine albumin (R 2 = 0.96).Conclusions In women with pre-eclampsia, random ACR is not stable during the day and cannot predict 24-hour urine protein excretion accurately. ACR from the 24-hour collection is an accurate predictor of total albumin amount and can be used to minimise errors from incomplete collections.Keywords Albumin/creatinine ratio, pre-eclampsia, proteinuria, protein/creatinine ratio.Please cite this paper as: Wikström A, Wikström J, Larsson A, Olovsson M. Random albumin/creatinine ratio for quantification of proteinuria in manifest pre-eclampsia. BJOG 2006; 113:930-934.

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“…Moreover, an additional advantage is the fact that only a single urine sample is required; thus the method is more cost-efficient and provides speedy results [18,19]. However, in the pregnant population, PCR has shown dissimilar performances, and to date consensus regarding its real usefulness and cutoff values in the differential diagnosis of PHD has not yet been achieved [20,21,22,23,24,25,26,27,28,29]. …”

Section: Introductionmentioning

confidence: 99%

Assessment of Protein:Creatinine Ratio versus 24-Hour Urine Protein in the Diagnosis of Preeclampsia

Valdés¹,

Sepúlveda‐Martínez

Tong³

et al. 2015

Gynecol Obstet Invest

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Background/Aims: Current evidence has tried to extrapolate the use of the protein:creatinine ratio (PCR) in a single urine sample as a rapid diagnostic tool for preeclampsia (PE). The present study addresses the effectiveness of the PCR in the differential diagnosis of the pregnancy hypertensive disorder (PHD). Methods: This is a prospective study conducted on patients admitted during 1 year with a diagnosis of PHD. These pregnant women were assessed for the correlation between the 24-hour test and the PCR to detect significant proteinuria. A ROC curve was made to determine the PCR cutoff value that would offer the best positive predictive value (PPV) as an early predictor of global and severe PE. Results: A total of 72 patients with 24-hour proteinuria and PCR were studied (49 with PE). A significant correlation between the quick and the deferred sampling was observed (r = 0.60; p < 0.001). The ROC analysis showed a PCR of 0.36 as the best cutoff value for the diagnosis of global PE (PPV 96.4%; false-positive rate 4.4%; AUC 0.8802) and a cutoff value of 4.58 (sensitivity: 100%; PPV 87.5%; false-positive rate 3.5%; AUC 0.9805) as the best cutoff for the diagnosis of severe proteinuria. Conclusions: PCR proved to be an effective test for the differential diagnosis of PHS.

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Protein/creatine ratio in random urine specimens for quantitation of proteinuria in preeclampsia

Cited by 25 publications

References 0 publications

A practical approach to using spot urine protein/creatinine ratios for assessing proteinuria in pregnancy

A practical approach to using spot urine protein/creatinine ratios for assessing proteinuria in pregnancy

Random albumin/creatinine ratio for quantification of proteinuria in manifest pre‐eclampsia

Assessment of Protein:Creatinine Ratio versus 24-Hour Urine Protein in the Diagnosis of Preeclampsia

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