Accuracy of urine dipsticks, 2-h and 12-h urine collections for protein measurement as compared with the 24-h collection

Abstract

The presence of protein in hypertensive disorders of pregnancy is a sign of a worsening condition and thus requires early intervention to prevent adverse consequences. Accurate assessment of proteinuria in patients with pre-eclampsia will ensure prompt and timely intervention to reduce or prevent the maternal and perinatal morbidity and mortality associated with pre-eclampsia. This study compared the reliability and validity of the more rapid diagnostic tests, such as the dipstick, 2-h and 12-h protein estimations with the 24-h protein. The result of the dipstick, 2-h and 12-h urine were also compared with the 24-h urine results using confidence interval (CI) for proportions with a value of p < 0.05 considered significant (CI 95%). When compared with the gold standard, there was a high degree of correlation between the 2-h (p = 0.244, CI 95%) and 12-h (p < 0.0255, CI 95%) with the 24-h sample in the quantification of proteinuria in women with pre-eclampsia. The most sensitive and specific test was the 12-h protein estimation, (89%) and (93%), respectively. The least sensitive and specific test was the dipstick test; (81%) and (47%), respectively. The 12-h protein estimation test had the highest positive predictive value (84%). The 12-h protein test also had the lowest false positive rate (12%) and false negative rates (11%), respectively. The most accurate test was the 12-h protein estimation (88%). The dipstick tests were however much cheaper and the results were faster. It is recommended that routine rapid quantisation of proteinuria in patients with pre-eclampsia be done using either the 2-h or 12-h urine sample.

Elevation of Urinary Adipsin in Preeclampsia

“…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.…”

“…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.…”

Establishing equations to evaluate 24 hour urine protein excretion using routine urinalysis

“…A reason might be that the method is substantive and direct. However, it is too inconvenient to collect completed 24 h urine, as many authors have declared . Nevertheless, in this study, 24 h UP measurement is still applied as a standard method.…”

Platelet Counts and Coagulation Tests Prior to Neuraxial Anesthesia in Patients With Preeclampsia

“…The inclusion of data on urinalysis to determine proteinuria was incorporated into the inclusion criteria as not all patients had 24-hour urine collection to confirm proteinuria of >300 mg/d or >3 g/d. Although 24-hour urinary protein studies are known to be more accurate than urinalysis in determining proteinurea in pregnancy, 27 we feel that our data reflects clinical practice as clinical care often needs to be delivered acutely for obstetric patients with preeclampsia before 24-hour urinary protein results become available. Preanesthesia coagulation tests were performed in 24% of laboring patients and 47% of patients undergoing cesarean delivery (undergoing a de novo anesthetic), therefore it is uncertain whether coagulation abnormalities existed in patients with preeclampsia within our study cohort, who did not receive preanesthesia coagulation testing.…”