Random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with preeclampsia

Abstract

In hospitalized preeclamptic patients, the random urinary protein-to-creatinine ratio at a cutoff of > or = 0.25 revealed a highly accurate prediction of significant proteinuria and could be a more practical alternative for assessment of proteinuria.

Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio

“…[1][2][3][4][5][6] Detecting and quantifying proteinuria is an integral part for both the diagnosis and assessment of severity of these disorders. The presence of significant proteinuria (>300 mg/day) is associated with higher maternal and fetal risks among hypertensive pregnancies.…”

“…1,[4][5][6][7][8][9] The amount of proteinuria is also directly related to the likelihood of obstetric complications. [5][6][7][8]10 However, the methods of reporting the presence or extent of proteinuria in hypertensive pregnancies are poorly described and standardized. 1,8 Detection of proteinuria in hypertensive pregnant women is usually done by routine simple visual dipstick urinalysis of a voided midstream sample.…”

“…1,7,8,11,12 Recent studies have, however, shown that this method is inaccurate with high false-positive and negative-results when compared to the gold standard of 24-h urine protein measurement. 1,2,[6][7][8]10,12,13 The latter measurement is also traditionally used for quantifying proteinuria in hypertensive pregnant women but has several limitations. [1][2][3][6][7][8][9][11][12][13][14][15][16][17][18] Most importantly, the laboratory results are not available to the clinician before 24 h, which may delay the ideal strategy for the immediate management of hypertension during pregnancy.…”

“…The accuracy of these investigations has been described in most studies of hypertensive and healthy pregnant women, 1,3,[5][6][7]11,[15][16][17][18][19][20][21] as well as nonpregnant healthy volunteers and patients with renal impairment. 15,17,18,22 These simple urine tests could assist in improving the clinical triage of hypertensive pregnant women with a potential for decreasing the workload of the maternity staff.…”

“…It would also reduce the demand and cost of laboratory services particularly in resource-constrained settings, like our own, where HDP are particularly prevalent. 5,6,8,17,18,[21][22][23] The aim of our study, therefore, was to evaluate the value of random urinary protein-creatinine and calcium-creatinine concentration in a consecutive sample of women with HDP in predicting 24-h proteinuria in our institution.…”