Urinary Protein/Creatinine Ratio in Hypertensive Pregnant Women

Abstract

The protein/creatinine ratio measured in a single urine sample taken at random from hypertensive pregnant women showed good sensitivity and specificity for the diagnosis of 24-h proteinuria > or = 300 mg and was strongly correlated with 24-h proteinuria. A ratio of 0.5 mg/mg is predictive of significant proteinuria and can be used for the diagnosis and follow-up of hypertensive pregnant women.

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

“…Some patients were ambulatory ad libitum, but were instructed to remain in the left lateral decubitus position when recumbent during the 24-h collection to avoid ureteral compression and inadequate collection. 5,18 Adequate 24-h collections were further defined as those containing at least 10 mg creatinine/kg pre-pregnancy weight in 24 h. 9,15,18 None of the spot samples was first-voided morning urine because of the diminished reliability of this specimen for measuring protein-creatinine ratio as a result of prolonged recumbency overnight. 6,14,16 Maternal demographic, obstetric and medical variables were abstracted from the case notes.…”

“…[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.…”

“…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.…”