Random urine protein to creatinine ratio as a diagnostic method of significant proteinuria in pre‐eclampsia

Zadehmodarres, Shahrzad; Razzaghi, Mohammad Reza; Habibi, Gholamreza; Najmi, Zahra; Jam, Hanieh; Mosaffa, Nariman; Kaboosi, Masomeh

doi:10.1111/j.1479-828x.2006.00649.x

Cited by 23 publications

(11 citation statements)

References 18 publications

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“…On the basis of an adequate 24-h urine collection and the Bradford method (as gold standard) to measure protein, we considered that the possibility of misclassification of a urine sample from a pregnant woman as positive or negative for significant proteinuria should be negligible. Consistent with previous studies (9,11,12,(21)(22)(23), our results demonstrate a strong correlation between 24-h proteinuria and the urine protein:creatinine ratio in pregnant women. The ROC curve analysis showed an area under the curve of 0.99, indicating that the urine protein:creatinine ratio is sufficiently accurate to either detect or rule out significant proteinuria, as confirmed with the optimal cutoff point at Ն0.3; this cutoff value yielded a high diagnostic performance with a sensitivity of 98.2% and specificity of 98.8%, as well as high positive and negative predictive values of 97.2% and 99.2%, respectively.…”

Section: Discussionsupporting

confidence: 82%

“…Nevertheless, 3 previous studies (9,12,23 ) that used optimal cutoff points similar to the one used by us [Ն0.25 to Ն0.30 (9,12,23 )], yielded sensitivities of 83%-96% and specificities of 92%-100%. Despite the smaller sample size used in these studies (42, 100, and 100 participants, respectively) the diagnostic performance of the tests, as indicated by 95% CIs, was similar to that found in the present study.…”

Section: Discussionmentioning

confidence: 99%

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Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Leaños‐Miranda¹,

Márquez-Acosta²,

Romero-Arauz

et al. 2007

Clinical Chemistry

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Background:The protein:creatinine ratio in random, untimed urine samples correlates with 24-h protein excretion in pregnant women with and without hypertension. Nevertheless, whether this ratio is appropriate as a screening test for proteinuria is still unclear, in part because of the paucity of large studies. Methods: We measured protein:creatinine ratios in random urine samples and protein contents of 24-h urine samples in a cross-sectional study of 927 hospitalized pregnant women at >20-weeks of gestational age and in a 2nd cohort of 161 pregnant women. In the 2nd group, urine specimens were obtained before and after completion of the 24-h collections, avoiding 1st-morning void specimens. Results: Protein excretion was >300 mg/24 h in 282 patients (30.4%). The urine protein:creatinine ratio and the 24-h protein excretion were significantly correlated (r ‫؍‬ 0.98, P <0.001). The protein:creatinine ratio as an indicator of protein excretion >300 mg/24 h was >0.3. The sensitivity and specificity were 98.2% and 98.8%, respectively. Positive and negative predictive values were 97.2% and 99.2%, respectively, and positive and negative likelihood ratios were 79.2 and 0.02, respectively. The diagnostic accuracy of the urinary protein: creatinine ratio was corroborated in the 2nd cohort of patients, which also showed no statistically significant

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Section: Discussionsupporting

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Leaños‐Miranda¹,

Márquez-Acosta²,

Romero-Arauz

et al. 2007

Clinical Chemistry

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“…Furthermore, several earlier studies on urinary Ca/Cr, 4 -7,28 -30 TP/Cr, 8,9,30 Malb/Cr 10,11,29,31 NAG/ Cr 11,32,33 and b 2 -mG/Cr ratios 11,34 in the second or third trimester of pregnancy have produced different results. We did not find significant differences in these biochemical parameters, except for urinary TP/Cr and Malb/Cr ratios.…”

Section: Discussionmentioning

confidence: 97%

“…Among them, decrease in the urinary calcium/creatinine (Ca/Cr) ratio 4 -7 and increase in urinary total protein (TP)/Cr, 8,9 microalbumin (Malb)/ Cr, 10,11 N-acetyl-b-D-glucosaminidase (NAG)/Cr and b 2--microgloburin (b 2 -mG)/Cr ratios 11 were reported to be useful for predicting the development of PE. However, these studies were performed in the second (16-27 weeks) or the third (28 -40 weeks) trimester of pregnancy, but not in the first trimester ( 15 weeks).…”

Section: Introductionmentioning

confidence: 99%

Increases in urinary creatinine and blood pressure during early pregnancy in pre-eclampsia

et al. 2010

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Background: It is important to predict the development of pre-eclampsia (PE) during early pregnancy to prevent its occurrence later on. In this study, we studied urinary biochemical parameters and blood pressure (BP) during and after pregnancy to find useful parameters for predicting PE. Methods: A case-control study was performed in 25 PE patients and 172 normotensive pregnant women. Twelve biochemical parameters were measured in spot urine, and the systolic and diastolic BPs were measured using an automated device during pregnancy and six to eight weeks after birth. Results: A multiple logistic regression analysis showed that the combinations of urinary creatinine (Cr) and systolic BP (SBP) in the first trimester of pregnancy (8.9 + 2.6 weeks), and of urinary inorganic phosphorus (IP)/Cr and SBP in the second trimester of pregnancy (19.0 + 1.6 weeks) were useful for predicting PE. The area under the curve in the receiver operator characteristic curve of the combination of urinary Cr and SBP in the first trimester was 0.85 (95% confidence interval [CI] 0.74-0.96), and that of the combination of urinary IP/Cr and SBP in the second trimester was 0.91 (95% CI: 0.86-0.97). When used 249 mg/dL in urinary Cr and 128 mmHg in SBP as their cut-off points, the combination in the first trimester increased the accuracy (sensitivity 75% and specificity 95%) in predicting PE, as compared with that of urinary Cr (29%, 99%) or SBP (50%, 98%). Conclusions: Combination of urinary Cr and SBP in early pregnancy and that of urinary IP/Cr and SBP in mid-pregnancy are useful for the prediction of PE.

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“…Otros estudios, que incluyeron un número menor a 150 pacientes, informan mejor desempeño operativo con otros puntos de corte que varían ampliamente. Entre ellos se han descrito valores de RPC para detección de proteinuria significativa de 0,20 (12,24), 0,21 (10), 0,22 (21) 0,26 (25) y 0,36 mg/ mg (26). El trabajo de Demirci et al, el cual incluyó 211 pacientes, encontró que 0,45 mg/mg es el punto de corte con mejor desempeño (16).…”

Section: Discussionunclassified

Evaluación de las características operativas de la relación proteína / creatinina en orina ocasional para la detección de proteinuria significativa en gestantes con sospecha de preeclampsia

Restrepo-Moreno

Arango-Buitrago

Gil-Pabón

et al. 2016

Rev. Colomb. Obstet. Ginecol.

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Objetivo: analizar la sensibilidad y especificidad de la relación proteína / creatinina en orina como método de detección de proteinuria en mujeres con sospecha de preeclampsia, teniendo en cuenta como estándar de oro la proteinuria en 24 horas. Materiales y métodos: en un estudio de corte transversal se incluyeron mujeres con embarazo mayor a 20 semanas, hospitalizadas en la Clínica Universitaria Bolivariana de Medellín por sospecha de preeclampsia. Se excluyeron gestantes con infección urinaria al momento del estudio, antecedentes de patologías crónicas que pudieran causar proteinuria y aquellas que no completaron la recolección de la muestra. A todas las pacientes se les realizó una medición de la relación proteína / creatinina en orina ocasional y la proteinuria en 24 horas. Se evaluó la correlación entre estas dos pruebas y el punto de corte de la relación proteína / creatinina con mejor rendimiento para la detección de proteinuria significativa. Resultados: se incluyeron 200 muestras de orina, encontrando proteinuria significativa en un 27 % del total de las muestras. La relación proteína / creatinina en orina ocasional mostró una alta correlación con la proteinuria de 24 horas (r = 0,775; p < 0,01). El punto de corte con mejor rendimiento para la detección de proteinuria significativa fue 0,30 mg/ mg, con una sensibilidad de 83 %, especificidad de 98 %, LR positivo de 60 y LR negativo de 0,17. Conclusión: la relación proteína / creatinina en orina ocasional puede ser usada como un método

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Random urine protein to creatinine ratio as a diagnostic method of significant proteinuria in pre‐eclampsia

Cited by 23 publications

References 18 publications

Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Protein:Creatinine Ratio in Random Urine Samples Is a Reliable Marker of Increased 24-Hour Protein Excretion in Hospitalized Women with Hypertensive Disorders of Pregnancy

Increases in urinary creatinine and blood pressure during early pregnancy in pre-eclampsia

Evaluación de las características operativas de la relación proteína / creatinina en orina ocasional para la detección de proteinuria significativa en gestantes con sospecha de preeclampsia

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