Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Abstract

Background:The protein:creatinine ratio in random, untimed urine samples correlates with 24-h protein excretion in pregnant women with and without hypertension. Nevertheless, whether this ratio is appropriate as a screening test for proteinuria is still unclear, in part because of the paucity of large studies. Methods: We measured protein:creatinine ratios in random urine samples and protein contents of 24-h urine samples in a cross-sectional study of 927 hospitalized pregnant women at >20-weeks of gestational age and in a 2nd cohort of 161 pregnant women. In the 2nd group, urine specimens were obtained before and after completion of the 24-h collections, avoiding 1st-morning void specimens. Results: Protein excretion was >300 mg/24 h in 282 patients (30.4%). The urine protein:creatinine ratio and the 24-h protein excretion were significantly correlated (r ‫؍‬ 0.98, P <0.001). The protein:creatinine ratio as an indicator of protein excretion >300 mg/24 h was >0.3. The sensitivity and specificity were 98.2% and 98.8%, respectively. Positive and negative predictive values were 97.2% and 99.2%, respectively, and positive and negative likelihood ratios were 79.2 and 0.02, respectively. The diagnostic accuracy of the urinary protein: creatinine ratio was corroborated in the 2nd cohort of patients, which also showed no statistically significant

Protein/Creatinine Ratio in Preeclampsia

“…The lines are parallel to each other, with varied area under the curves. Leanos-Miranda et al 24 was not included in the graph because the study did not provide values for different protein/creatinine ratio cut points. However, with an area under the curve of 0.998, the graph would be at the top and left corner.…”

Circulating Angiogenic Factors and Urinary Prolactin as Predictors of Adverse Outcomes in Women With Preeclampsia

“…Mild preeclampsia (mPE) was diagnosed when the systolic or diastolic blood pressure were ≥140 mm Hg or ≥90 mm Hg, respectively, measured twice at least 6 hours apart along with significant proteinuria (≥300 mg of protein in a 24-hour urine specimen or a protein:creatinine ratio ≥0.30 in a random urine sample). 18 Severe preeclampsia (sPE) was considered on finding either HELLP syndrome (hemolysis, elevated liver enzymes, low platelet count), eclamspia, or preeclampsia along with severe hypertension (systolic blood pressure ≥160 mm Hg or diastolic blood pressure ≥110 mm Hg on at least 2 occasions 6 hours apart) or massive proteinuria (≥5 g/d or a protein:creatinine ratio ≥3.87).…”

RETIRED: Diagnosis, Evaluation, and Management of the Hypertensive Disorders of Pregnancy

“…Outside pregnancy, early morning urine samples should be tested as the most concentrated of the day [34][35][36][37].…”