Random urine protein/creatinine ratio readily predicts proteinuria in preeclampsia

Abstract

ObjectiveTo assess the diagnostic accuracy of random urine protein-creatinine (P/C) ratio for prediction of significant proteinuria in preeclampsia as an alternative to the time-consuming 24-hour urine protein collection.MethodsRetrospective record analysis was performed on 140 pregnant women who were admitted with suspicion for preeclampsia from January 2006 to June 2011. Random urine protein and/or 24-hour urine protein levels were assessed and their correlation to random urine P/C ratio and 24-hour urine protein excretion was evaluated.ResultsOut of 140 patients, random urine P/C ratio or/and 24-hour urine protein was performed in 79 patients to evaluate significant proteinuria. Of 79 patients, 46 (58%) underwent both tests whereas in 33 women (42%) 24-hour urine collection was not available due to urgent delivery. In 39 cases (85%), significant proteinuria (≥300 mg/24 hr) was detected with 6 cases (13%) having values over 5,000 mg/24 hr, corresponding to the diagnosis of severe preeclampsia. Random urine P/C ratio highly correlated with 24-hour urine protein excretion (r=0.823, P<0.01). The optimal random urine P/C ratio cutoff points were 0.63 and 4.68 for 300 mg/24 hr and 5,000 mg/24 hr of protein excretion, respectively. with each sensitivity, specificity, and positive and negative predictive values of 87.1%, 100%, 100%, and 58.3%; and 100%, 85%, 50%, and 100%, for significant and severe preeclampsia, respectively.ConclusionRandom urine P/C ratio is a reliable indicator of significant proteinuria in preeclampsia and may be better at providing earlier diagnostic information than the 24-hour urine protein excretion with more accuracy than the urinary dipstick test.

Predictive value of 4-, 8-, and 12-h urine protein and protein-to-creatinine ratio for detection of pre-eclampsia

“…The present study showed a significant correlation of both protein excretion and PCR values among samples collected over 4 h, 8 h, 12 h, and 24 h. Many studies have established the utility of urine PCR, presenting evidence of a good correlation with acceptable sensitivity for predicting significant proteinuria on the basis of urine samples collected at different times [6].…”

“…Measurement of 24‐h urine protein excretion has been the gold standard for quantifying urinary protein. However, it is an inconvenient and time‐consuming test, both for the woman and for the staff collecting the sample [3–5], in a situation when the timely and accurate diagnosis of pre‐eclampsia is essential to avoid significant maternal and fetal morbidity and mortality [6].…”

A comparative study of pregnancy outcome among women with preeclampsia and normotensive at the Alex Ekwueme Federal University Teaching Hospital Abakaliki, Nigeria

“…2019 Oct;7(10): [3789][3790][3791][3792][3793][3794] International Journal of Research in Medical Sciences | October 2019 | Vol 7 | Issue 10 Page 3790 perinatal morbidity and mortality. 3 Overall, 10%-15% of maternal deaths are directly associated with preeclampsia and eclampsia. 4,5 The prevalence reported in some hospital based studies in Nigeria ranged from 1.2-10%.…”

Diabetic Nephropathy; Protein to Creatinine Ratio as a Cost Effective Diagnostic Tool for Detection

“…Park., et al decided that Random urine P:c ratio is consistent marker of significant proteinuria in preeclampsia and possibly be better at providing earlier diagnostic information as compared to 24-hour urine protein excretion and having more correctness as compared to urinary dipstick test (12).Some researchers projected that more accurate and rapid diagnostic test having the ability of predicting 24-hour urine protein excretion would be highly important, by using random urine P.C ratio to simplify prompt decision making by clinicians. 13,14 Usefulness of random urine P.C ratio have been established already by numerous scientists , as well as some that have accessible indication of good association with adequate sensitivity in forecasting significant proteinuria founded on urine collected at different time periods.…”