Protein-creatinine ratio and albumin-creatinine ratio for the diagnosis of significant proteinuria in pregnant women with hypertension: Systematic review and meta-analysis of diagnostic test accuracy

Cross‐sectional diagnostic accuracy study of self‐testing for proteinuria during hypertensive pregnancies: The UDIP study

“…These findings align with pilot work using synthetic urine samples, which reported that healthcare professionals and pregnant women tested with similar accuracy, and the sensitivity and specificity of both index tests were comparable to those reported in this study (>70%) 6 . The differences between this study and previous studies could be due to the reference test; two studies that reported a low sensitivity for dipstick urinalysis used 24‐hour urine collection as the reference standard, 23,24 which is less accurate than a PCR test 15 . Population differences could also account for discordant findings; one previously conducted study included non‐hypertensive pregnant women and therefore had a lower prevalence of proteinuria 25 .…”

“…This is motivated by the variation in protein excretion during the day and from day to day, and is intended to prevent a diagnosis of pre‐eclampsia on the basis of one raised PCR result 2 . Previous evidence suggests that 30–50 mg/mmol is the range in which repeat laboratory testing would be beneficial 14,15 …”

“…2 Previous evidence suggests that 30-50 mg/mmol is the range in which repeat laboratory testing would be beneficial. 14,15 Importantly, urinalysis is not done in isolation: women are asked about symptoms and have their blood pressure checked, and tests are repeated where any sign or symptom is of concern. The low proportion of false positives has fewer clinical implications, as this is a screening test where positive results are quantified with a laboratory test.…”

Preeklampsi̇ Tanisinda Spot İdrar Protei̇n / Kreati̇ni̇n Oraninin Sensi̇ti̇vi̇tesi̇ni̇n İdrar Verme Zamani Ve Bekleme Süresi̇ Gi̇bi̇ Deği̇şkenler İle Bi̇rli̇kte Beli̇rlenmesi̇

“…A meta-analysis conducted in 2021 a diagnostic test accuracy for both sensitivity and specificity was higher when the first morning void was excluded (excluded first void: sensitivity 93%, specificity 93%; did not specifically exclude first void: sensitivity 87%, specificity 84%) (19). The high specificity and sensitivity, excluding the patient's first voiding, can be explained by the fact that the patient is resting all night, and suggests that the protein/creatinine ratio may change during the day.…”

Practical guide for the management of hypertensive disorders during pregnancy

“…The most recent meta-analysis at the field, showed that PCR and ACR have high accuracy compared with the gold standard, 24-h urine collection. Specifically, PCR offers high sensitivity (91%) and specificity (89%) at a threshold of 30 mg/mmol and ACR indicates significant proteinuria at less than 2 mg/ mmol [12,44].…”