Quantifying Proteinuria in Hypertensive Disorders of Pregnancy

Amin, Sapna Vinit; Illipilla, Sireesha; Hebbar, Shripad; Rai, Lavanya; Kumar, Pratap; Pai, Muralidhar

doi:10.1155/2014/941408

Cited by 20 publications

(25 citation statements)

References 21 publications

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“…Generally, the estimation of 24 h urine proteins has been considered the gold standard for quantitation of proteinuria [7]. However, the collection of a 24 h urine sample is inconvenient for the patient and prone to pre-analytical errors, thereby leading to inaccurate results or variations in the application of the assay [8].…”

Section: Introductionmentioning

confidence: 99%

Comparisons of Dipstick Test, Urine Protein-to-Creatine Ratio, and Total Protein Measurement for the Diagnosis of Preeclampsia

Stefańska

Zieliński

Zamkowska

et al. 2020

IJERPH

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Preeclampsia affects 2–5% of pregnant women and is one of the leading causes of maternal and perinatal morbidity and mortality. We aimed to extensively evaluate proteinuria in women with preeclampsia and to determine the analytical sensitivity and specificity of and the cutoff values for urine protein-to-creatinine ratio (UPCR) and total protein in 24 h urine samples. This study included 88 women. We used the urine dipstick test, UPCR, and total protein measurement in a 24 h urine sample. The patients were divided in gestational hypertension (GH, n = 44) and preeclampsia (PE, n = 44) groups. In the GH group, 25% (11/44) of the patients presented incidentally positive results. UPCR and total protein in 24 h urine specimens were increased in the GH group compared to the PE group. Receiver operating characteristic analysis showed a UPCR cutoff of 30 mg/mmol as significant for preeclampsia, while the sensitivity and specificity were 89% (95% CI, 75–97) and 100% (95% CI, 87–100), respectively. In the 24 h urine protein test, sensitivity and specificity were 80% (95% CI, 61–92) and 100% (95% CI, 88–100), respectively, for the cutoff value of 0.26 g/24 h. In comparison to the other commonly used tests here considered, UPCR determination is a reliable, relatively faster, and equally accurate method for the quantitation of proteinuria, correlates well with 24 h urine protein estimations, and could be used as an alternative to the 24 h proteinuria test for the diagnosis of preeclampsia.

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Section: Introductionmentioning

confidence: 99%

Comparisons of Dipstick Test, Urine Protein-to-Creatine Ratio, and Total Protein Measurement for the Diagnosis of Preeclampsia

Stefańska

Zieliński

Zamkowska

et al. 2020

IJERPH

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show abstract

“…Nisell H et al in 2006 and Rathindranath R et al in 2015 suggested that in most cases the more cumbersome 24 hour urine collection can be replaced by the more convenient albumin/creatinine ratio on spot urine [8,9]. Amin SV et al in 2014 showed that area under curve for urinary protein: creatine ratio (UPCR) was 0.89 (95% CI: 0.83 to 0.95), it had sensitivity of 82% and false positive rate of 12.5% for cutoff value of 0.45 (Figure 2) [10]. They used higher cutoff values (1.46 and 1.83) for prediction of heavy proteinuria (2 g and 3 g/24 h, respectively).…”

Section: The Quantity Of Protein Loss Has Both Diagnostic and Prognostic Implications But What Constitutes An Ideal Test Or Cut Off Valuementioning

confidence: 99%

Urinary Spot Albumin/Creatinine Ratio for Documenting Proteinuria in Women with Hypertensive Disorders with Pregnancy

2018

J Androl Gynaecol

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Background: Although, twenty-four hour urine collection was considered the gold standard for quantification of proteinuria, it has many limitations. It is cumbersome for the patient and often inaccurate because of under collection and result availability is delayed for at least 24 hours. The spot albumin creatinine (A/C) ratio use in pregnancy has been extensively studied. Its use has been adopted by some authors as they found that it had been significantly correlated to 24 hour urinary protein estimation while others did not support its use as in cases of preeclampsia kidney function may deteriorate rapidly.Objective: To evaluate the accuracy of random urine albumin/ creatinine ratio as a diagnostic method for quantitative evaluation of proteinuria in hypertensive disorders in pregnant women.Methods: A total of 70 patients fulfilling inclusion criteria were evaluated with urine albumin/creatinine ratio performed on random voided sample. The entire 24 hour urine sample was collected and analyzed for daily protein excretion. A/C ratio was compared to the 24 hour results.Results: There was significant positive correlation detected between A/C ratio and 24 hour protein at a cutoff value of 347.35 mg/gm. Area under curve for A/C ratio was 0.730 (P<0.001) showing sensitivity 80.6% and specificity 51.2% to detect protein excretion of 300 mg/24 hr. While, there was significant negative correlation detected between A/C ratio and urine creatinine. Conclusion:Random A/C ratio could be used as a rapid, easy and reliable test for diagnosis of significant proteinuria in hypertensive disorders with pregnancy, so it can substitute 24 hour urinary protein collection.

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“…Protein excre on may vary during different mes of day but when divided by spot crea nine which is constant during the day, UPCR ra o forms a reliable indicator of proteinuria. It doesn't require admission, is convenient and reports are 6 available fast thus helping for early planning.…”

Section: Introductionmentioning

confidence: 99%

Study of Protein/creatinine Ratio in Preeclampsia as an Alternative to 24 Hours Urine Protein in Manipal Teaching Hospital of Nepal

Shrestha

2018

Birat J. Health Sci.

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Introduction: Hypertensive disorder in pregnancy complicates around 5 to 10% of all pregnancies. It is one of the leading causes of maternal and fetal morbidity and mortality. Measurement of protein excretion by 24 -hour urine protein collection is gold standard but as it is time consuming, an alternative method like random urine protein/creatinine ratio is required.Objectives: The aim of this study was to assess the diagnostic accuracy of urine protein/ creatinine ratio compared with 24-hour urine protein as an alternative method for evaluating proteinuria in preeclampsia.Methodology: Patients with preeclampsia after 20 weeks of gestation were included in the study. Random urine protein/ creatinine ratio and 24-hour urine for protein was collected and evaluated for proteinuria. Results were entered and analysis was done.Results: Fisher's exact test depicted a positive association between UPCR with 24-hour urine protein, p value being less than 0.05. The area under curve was calculated as 0.87 95% CI (0.74-1.01), which was statistically significant. At cut off point of 0.3, sensitivity was 100%, specificity 90%, positive and negative predictive value 97.2% and 100% respectively.Conclusion: Random urine protein/ creatinine ratio (>0.3) is a reliable indicator of proteinuria >300mg/day. It can be used as an alternative to 24-hour protein estimation. BJHS 2018;3(1)5 : 350-353

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Quantifying Proteinuria in Hypertensive Disorders of Pregnancy

Cited by 20 publications

References 21 publications

Comparisons of Dipstick Test, Urine Protein-to-Creatine Ratio, and Total Protein Measurement for the Diagnosis of Preeclampsia

Comparisons of Dipstick Test, Urine Protein-to-Creatine Ratio, and Total Protein Measurement for the Diagnosis of Preeclampsia

Urinary Spot Albumin/Creatinine Ratio for Documenting Proteinuria in Women with Hypertensive Disorders with Pregnancy

Study of Protein/creatinine Ratio in Preeclampsia as an Alternative to 24 Hours Urine Protein in Manipal Teaching Hospital of Nepal

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