Protein/Creatinine Ratio in Preeclampsia

Papanna, Ramesha; Mann, Lovepreet K.; Kouides, Ruth; Glantz, J. Christopher

doi:10.1097/aog.0b013e3181778cfc

Cited by 73 publications

(46 citation statements)

References 29 publications

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“…According to another study random UPC ratio is helpful primarily when it is below 150 mg/g creatinine, in that proteinuria of more than 300 mg is unlikely below this threshold. The accuracy of this UPC ratio in predicting 300 mg of protein in 24-h urine collection in pregnant patients with suspected preeclampsia had a sensitivity ranged from 90%-99% and specificity ranged from 33%-65% [15] . In contrast to that UPC ratio and 24-h urine total protein level showed a poor correlation with negative predictive value of 47.5% and specificity of 55.8% in a study of 220 women by Durnwald et al [16] Nevertheless he same authors admit that UPD ratio can predict severe preeclampsia and thus can be used for rapid diagnosis of severe preeclampsia as the correlation of UPD ratio and 24-h proteinuria increases with the amount of proteinuria.…”

Section: Proteinuria In Pregnancymentioning

confidence: 99%

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Müller-Deile

Schiffer

2014

WJN

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Proteinuria is a frequently detected symptom, found in 20% of pregnancies. A common reason for proteinuria in pregnancy is preeclampsia. To diagnose preeclampsia clinically and to get new insights into the pathophysiology of the disease it is at first essential to be familiar with conditions in normal pregnancy. Animal models and biomarkers can help to learn more about disease conditions and to find new treatment strategies. In this article we review the changes in kidney function during normal pregnancy and the differential diagnosis of proteinuria in pregnancy. We summarize different pathophysiological theories of preeclampsia with a special focus on the renal facets of the disease. We describe the current animal models and give a broad overview of different biomarkers that were reported to predict preeclampsia or have a prognostic value in preeclampsia cases. We end with a summary of treatment options for preeclampsia related symptoms including the use of plasmapheresis as a rescue therapy for so far refractory preeclampsia. Most of these novel biomarkers for preeclampsia are not yet implemented in clinical use. Therefore, we recommend using proteinuria (measured by UPC ratio) as a screening parameter for preeclampsia. Delivery is the only curative treatment for preeclampsia. In early preeclampsia the primary therapy goal is to prolong pregnancy until a state were the child has an acceptable chance of survival after delivery.© 2014 Baishideng Publishing Group Inc. All rights reserved.Key words: Preeclampsia; Pregnancy; Proteinuria; Biomarkers; Treatment Core tip: This review summarises different pathophysiological theories of preeclampsia with a special focus on the renal facets of the disease. In this context current animal models are presented. The reader gets a broad overview about different biomarkers for preeclampsia. Furthermore, the article discusses treatment options for preeclampsia related symptoms including the use of plasmapheresis as a rescue therapy for so far refractory preeclampsia.Müller-Deile J, Schiffer M. Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy. World

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Section: Proteinuria In Pregnancymentioning

confidence: 99%

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Müller-Deile

Schiffer

2014

WJN

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“…Since this assertion, many groups have identified or studied potential biochemical and/or biophysical markers based on physiological mechanisms, some of which showing encouraging results. Systematic reviews and/or metaanalyses assessing the clinical utility of, most often, single markers, have recently been published (25)(26)(27)(28), but so far no marker has demonstrated an appropriately high accuracy level to justify its clinical application.…”

confidence: 99%

Combining Biochemical and Ultrasonographic Markers in Predicting Preeclampsia: A Systematic Review

et al. 2010

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BACKGROUND: Early identification of pregnant women at risk for preeclampsia is a priority to implement preventive measures. Some biochemical and ultrasonographic parameters have shown promising predictive performance, but so far there is no clinically validated screening procedure.CONTENT: Using a series of keywords, we reviewed electronic databases (Medline, Embase, all records to May 2009) reporting the performance of biological and ultrasonographic markers to predict preeclampsia, both single markers and combinations of markers. We analyzed the data according to gestational age and risk levels of the studied populations. We evaluated the methodological quality of included publications using QUADAS (quality assessment of diagnostic accuracy studies). We identified 37 relevant studies that assessed 71 different combinations of biochemical and ultrasonographic markers. Most studies were performed during the second trimester on small-scale high-risk populations with few cases of preeclampsia. Combinations of markers generally led to an increase in sensitivity and/or specificity compared with single markers. In low-risk populations, combinations including placental protein 13 (PP13), pregnancy-associated plasma protein A (PAPP-A), a disintegrin and metalloprotease-12 (ADAM12), activin A, or inhibin A measured in first or early second trimester and uterine artery Doppler in second trimester appear promising (sensitivity 60%-80%, specificity Ͼ80%). In high-risk populations, the combination of PP13 and pulsatility index in first tri-

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“…El trabajo de Demirci et al, el cual incluyó 211 pacientes, encontró que 0,45 mg/mg es el punto de corte con mejor desempeño (16). Las variaciones observadas se deben probablemente a la falta de homogeneidad en la metodología de los estudios, el número de pacientes incluidos, y las diferencias en las escalas, unidades de medida e instrumentos de laboratorio utilizados, entre otros (13,20).…”

Section: Discussionunclassified

“…Esto se puede atribuir a las variaciones metodológicas entre los estudios (13,20). El objetivo de este estudio es analizar la RPC como método de detección de proteinuria significativa en mujeres con THAE, su sensibilidad y especificidad en diferentes puntos de corte, teniendo en cuenta como estándar de oro la P24.…”

Section: Introductionunclassified

Evaluación de las características operativas de la relación proteína / creatinina en orina ocasional para la detección de proteinuria significativa en gestantes con sospecha de preeclampsia

Restrepo-Moreno

Arango-Buitrago

Gil-Pabón

et al. 2016

Rev. Colomb. Obstet. Ginecol.

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Objetivo: analizar la sensibilidad y especificidad de la relación proteína / creatinina en orina como método de detección de proteinuria en mujeres con sospecha de preeclampsia, teniendo en cuenta como estándar de oro la proteinuria en 24 horas. Materiales y métodos: en un estudio de corte transversal se incluyeron mujeres con embarazo mayor a 20 semanas, hospitalizadas en la Clínica Universitaria Bolivariana de Medellín por sospecha de preeclampsia. Se excluyeron gestantes con infección urinaria al momento del estudio, antecedentes de patologías crónicas que pudieran causar proteinuria y aquellas que no completaron la recolección de la muestra. A todas las pacientes se les realizó una medición de la relación proteína / creatinina en orina ocasional y la proteinuria en 24 horas. Se evaluó la correlación entre estas dos pruebas y el punto de corte de la relación proteína / creatinina con mejor rendimiento para la detección de proteinuria significativa. Resultados: se incluyeron 200 muestras de orina, encontrando proteinuria significativa en un 27 % del total de las muestras. La relación proteína / creatinina en orina ocasional mostró una alta correlación con la proteinuria de 24 horas (r = 0,775; p < 0,01). El punto de corte con mejor rendimiento para la detección de proteinuria significativa fue 0,30 mg/ mg, con una sensibilidad de 83 %, especificidad de 98 %, LR positivo de 60 y LR negativo de 0,17. Conclusión: la relación proteína / creatinina en orina ocasional puede ser usada como un método

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Protein/Creatinine Ratio in Preeclampsia

Cited by 73 publications

References 29 publications

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Preeclampsia from a renal point of view: Insides into disease models, biomarkers and therapy

Combining Biochemical and Ultrasonographic Markers in Predicting Preeclampsia: A Systematic Review

Evaluación de las características operativas de la relación proteína / creatinina en orina ocasional para la detección de proteinuria significativa en gestantes con sospecha de preeclampsia

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