Accuracy of the spot urinary microalbumin:creatinine ratio and visual dipsticks in hypertensive pregnant women

Gangaram, Rajesh; Naicker, Manogaran; Moodley, Jagidesa

doi:10.1016/j.ejogrb.2009.03.010

Cited by 21 publications

(15 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The mean age of gestation at the time of presentation was 34.5 weeks. These findings are in accordance with the previous studies in which the mean age of gestation at the time of presentation was 34 weeks [19]. The prevalence of complications in our patients was high (up to 60%).…”

Section: Discussionsupporting

confidence: 93%

Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

Kumari

Chakrawarty

Singh

et al. 2014

Journal of Pregnancy

View full text Add to dashboard Cite

Objective. To investigate association between maternofoetal complications and the amount of proteinuria measured by spot urine protein creatinine ratio in patients with preeclampsia. Methods. 200 consecutive patients with preeclampsia were recruited in the study. The complications like first episode of severe hypertension, renal insufficiency, raised level of aspartate transaminase, signs of neurological involvement, thrombocytopenia, eclampsia, and need to shift in intensive care units were studied. The maternal outcome was studied in terms of type of labour, outcome of pregnancy, mode of delivery, indication of cesarean section, and maternal mortality. The foetal complications and outcome parameters were birth weight, Apgar score at the time of birth and at five minutes, need of high dependency unit care, and perinatal mortality. Result. The frequency of various maternal and foetal complications was between 14–53% and 22–92%, respectively. Maternal mortality was 3%, whereas perinatal mortality was 23%. Statistically significant association was found between the frequencies of various complications in mother and newborn and spot UPCR. Conclusion. The rate of various maternofoetal complications in preeclampsia is higher in developing countries than in developed world. Maternofoetal complications and outcome correlate with maternal spot UPCR.

show abstract

Section: Discussionsupporting

confidence: 93%

Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

Kumari

Chakrawarty

Singh

et al. 2014

Journal of Pregnancy

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

“…Furthermore, this rapid test seemed to have a better value than the dipstick test, which has a sensitivity and specificity in the range of 51% to 81% and 47% to 91%, respectively. [22][23][24][25] Financially, inexpensive materials are used to build the strip test, and the use of such a kit could be more affordable than a dipstick test.Because this is the first time that adipsin is described as a urinary biomarker based on the kidney injury in preeclampsia, further studies are needed to validate these findings and correlate urinary adipsin to adverse maternal outcomes such as severe hypertension, HELLP syndrome, and eclampsia besides intrauterine growth restriction. Adipsin needs to be investigated in women with underlying renal diseases (lupus, diabetes mellitus, and chronic hypertension) in terms of defining the specificity to preeclampsia.…”

mentioning

confidence: 99%

Elevation of Urinary Adipsin in Preeclampsia

et al. 2014

View full text Add to dashboard Cite

846P reeclampsia, a devastating pregnancy-specific syndrome complicating 2% to 8% of pregnancies, is responsible for ≈60 000 maternal deaths worldwide every year. It is characterized by new-onset hypertension, proteinuria, and edema and usually develops after 20 weeks of gestation.1,2 Early diagnosis and treatment of preeclampsia is essential for prevention of seizure development and maintaining the fetus in the uterus to mature. Many attempts have been made to meet these purposes. It has been found that altered concentration of soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PIGF) can predict the occurrence of preeclampsia weeks before the appearance of the clinical symptoms. [3][4][5][6] Uterine artery Doppler studies that assess the pulsability index reveal increased uterine vascular resistance well before the preeclampsia clinical signs arise.7 These predictive tests are valuable for identifying highrisk pregnant women but are incapable of conveniently monitoring the exact occurrence of the disease. In this study, we assumed that in preeclampsia a urinary protein that closely correlated with the 24-hour urine protein could be identified with advanced proteomics technologies and could be developed as a simple rapid assay for point-of-care use and for home monitoring as well.In 1843, John Lever of Guy's Hospital in London discovered the presence of albumin by boiling the urine from pregnant women with puerperal convulsions. 8 Proteinuria in preeclampsia since then has been studied extensively. The glomerular injury that results in proteinuria is characterized as endotheliosis, manifested as glomerular endothelial swelling with loss of endothelia fenestrae and occlusion of the capillary lumens.9,10 Proteinuria is measured currently by a 24-hour urine protein determination or a dipstick examination on a random urine sample. The 24-hour urine protein quantification is no doubt the most accurate and reliable approach but is time consuming and inconvenient. Dipstick is semiquantitative, easy to use, quick, and inexpensive. However, many studies have reported a poor correlation between the dipstick examination and the 24-hour urine assay with high false-positive or false-negative rates. 11,12 We aimed to find a urine protein in preeclampsia that closely correlated with the 24-hour urine protein and was at a Abstract-Early diagnosis and treatment of preeclampsia are essential for prevention of seizure development and fetus maturation. Although various methods have been developed for predicting or monitoring the onset of preeclampsia, a simple assay that can be used as a home or point of care test remains unavailable. We attempted to find a urinary protein that could be used as a biomarker for developing such a test. Urinary samples were collected from 124 preeclampsia and 135 healthy pregnant women for screening using a protein array technology and quantification by ELISA. A urinary protein, adipsin, was found significantly increased, and the adipsin creatinine ratio was closely correlated wi...

show abstract

“…19,31 Some but not all past studies have shown an excellent correlation between a spot urinary ACR and albumin excretion in a 24-hour urine sample in normal pregnancy and pre-eclampsia. [32][33][34][35][36] Many previous studies have measured microalbuminuria in an attempt to predict pre-eclampsia in early pregnancy, postulating that the stage of gross proteinuria is preceded by the stage of microalbuminuria. Using regression models, Bar et al 16 identified the presence of microalbuminuria at 28-30 weeks of gestation to be predictive of subsequent pre-eclampsia, with an odds ratio of 2.1 (95% CI 1.26-3.53).…”

Section: Discussionmentioning

confidence: 99%

Prediction of pre-eclampsia in early pregnancy by estimating the spot urinary albumin: creatinine ratio using high-performance liquid chromatography

Baweja

Kent

Masterson

et al. 2011

BJOG: An International Journal of Obstetrics &Amp; Gynaecology

View full text Add to dashboard Cite

Objective To establish whether a spot urinary albumin: creatinine ratio (ACR) measured before 20 weeks of gestation can predict subsequent pre-eclampsia when urinary albumin is measured by high-performance liquid chromatography (HPLC).Design Prospective exploratory study.Setting Antenatal clinic in a tertiary teaching hospital, Victoria, Australia.Population A cohort of 265 women with a singleton pregnancy, normal renal function, and no evident proteinuria, attending antenatal clinics between 12 and 20 weeks of gestation.Methods The ACR was determined from a mid-stream urine (MSU) sample taken between 17 and 20 weeks of gestation. Intact urinary albumin was determined by HPLC; creatinine was measured by modified Jaffe's method.Outcome measures Pre-eclampsia (primary); gestational hypertension, small for gestational age (SGA), gestational diabetes mellitus, gestational age at delivery, and prematurity (secondary).Results The median ACR was 28 mg/mmol (IQR 16-46 mg/ mmol). Women who subsequently developed pre-eclampsia had a significantly higher ACR (median 50 mg/mmol; IQR 33-90 mg/ mmol) compared with women suffering from gestational hypertension (median 27 mg/mmol; IQR 8-35 mg/mmol), and compared with unaffected women (median 28 mg/mmol; IQR 16-46 mg/mmol). Mothers of SGA infants also had a significantly higher median ACR. By ROC analysis, the optimum ACR to predict pre-eclampsia was 35.5 mg/mmol: the relative risk of developing pre-eclampsia in women with a urinary ACR ‡ 35.5 mg/mmol was 7.8 times more than in those with a urinary ACR < 35.5 mg/mmol.Conclusions When urinary albumin is measured by HPLC, spot urinary ACR values are higher in early uncomplicated pregnancy compared with previously reported conventional methods. When measured early in the second trimester, an ACR ‡ 35.5 mg/mmol predicted pre-eclampsia well before the onset of clinical manifestations.

show abstract

Accuracy of the spot urinary microalbumin:creatinine ratio and visual dipsticks in hypertensive pregnant women

Cited by 21 publications

References 10 publications

Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

Maternofoetal Complications and Their Association with Proteinuria in a Tertiary Care Hospital of a Developing Country

Elevation of Urinary Adipsin in Preeclampsia

Prediction of pre-eclampsia in early pregnancy by estimating the spot urinary albumin: creatinine ratio using high-performance liquid chromatography

Contact Info

Product

Resources

About