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

Abstract

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

Correlation of Spot Urine Albumin to Creatinine Ratio and 24-Hrs. Urinary Protein Excretion in Pregnancy Induced Hypertension Cases

“…In a similar study involving Indian pregnant women, Shrestha et al 11 (2018) reported a similar positive predictive value of 97.2% for spot urinary protein to creatinine ratio in the diagnosis of preeclampsia. Similar results have also been reported by Bhadarka et al 31 (2018) and Shreya et al 32 (2015) in other Indian studies who observed the PPV of spot urinary protein to creatinine ratio to be 95.0% and 94.0% respectively.…”

“…2 Recent studies claimed that urinary protein to creatinine ratio in a spot urine specimen was equally reliable in the diagnosis of preeclampsia but it was relatively quicker in sample collection and reporting and could improve the outcome by saving valuable time. [9][10][11][12] However, there was a controversy in the existing literature [9][10][11][12][13] regarding the positive predictive value of spot urinary protein to creatinine ratio, which caused the present study. The aim of this study was to determine the positive predictive value of spot urinary protein to creatinine ratio for the diagnosis of pre-eclampsia, taking 24-hour urinary protein as the gold standard.…”

“…Demirci et al 10 in 2015 conducted a similar study and found that the positive predictive value was 95.2%. Shrestha et al 11 conducted a similar study in 2018 and found that the positive predictive value was 97.2%. Mohseni et al 12 (2013) in a similar study reported the PPV to be 92.0%.…”