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Protein/creatinine ratio versus 24-hours urine protein in preeclampsia
Affiliations- Department of Obstetrics, and Gynaecology, Ain Shams University, Cairo, Egypt
- Ahmadi Hospital, Kuwait Oil Company (KOC), Ahmadi, Kuwait
- Ghamra Military Hospital, Cairo, Egypt
- West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan
open access
Abstract
Objectives: Proteinuria is one of the diagnostic criteria of preeclampsia (PE). Measurement of 24-hour urine protein is the gold standard method for detection of proteinuria in PE. The 24-hour urine sampling is time-consuming, and inconvenient. To evaluate the accuracy of protein/creatinine (P/C) ratio in detection of significant proteinuria (> 1 g/24-hours urine) in PE.
Material and methods: One hundred and ten (110) preeclamptic women were included in this study and admitted for blood pressure monitoring, 24-hour urine collection, fetal well-being assessment and spot urine sample for measuring of P/C ratio. After thorough history and clinical examination, routine antenatal investigations were done for the women included in the study according to the hospital`s protocol, and to exclude pre-existing chronic renal disease. Twenty-four-hour urine collection started on the morning following hospital admission. Spot urine samples were obtained shortly before the 24-hour urine collection for measuring of P/C ratio. Collected data statistically analyzed to evaluate the accuracy of P/C ratio in detection of significant proteinuria in PE.
Results: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% positive predictive value (PPV), 90.2% negative predictive value (NPV), and 94.5% overall accuracy in detection of significant proteinuria (> 1 g/24-hour urine) in PE.
Conclusions: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% PPV, 90.2% NPV, and 94.5% overall accuracy in detection of significant proteinuria (> 1 g/24-hour urine) in PE. This study suggests the use of P/C ratio as an alternative to 24-hour urine protein to detect significant proteinuria in PE.
Abstract
Objectives: Proteinuria is one of the diagnostic criteria of preeclampsia (PE). Measurement of 24-hour urine protein is the gold standard method for detection of proteinuria in PE. The 24-hour urine sampling is time-consuming, and inconvenient. To evaluate the accuracy of protein/creatinine (P/C) ratio in detection of significant proteinuria (> 1 g/24-hours urine) in PE.
Material and methods: One hundred and ten (110) preeclamptic women were included in this study and admitted for blood pressure monitoring, 24-hour urine collection, fetal well-being assessment and spot urine sample for measuring of P/C ratio. After thorough history and clinical examination, routine antenatal investigations were done for the women included in the study according to the hospital`s protocol, and to exclude pre-existing chronic renal disease. Twenty-four-hour urine collection started on the morning following hospital admission. Spot urine samples were obtained shortly before the 24-hour urine collection for measuring of P/C ratio. Collected data statistically analyzed to evaluate the accuracy of P/C ratio in detection of significant proteinuria in PE.
Results: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% positive predictive value (PPV), 90.2% negative predictive value (NPV), and 94.5% overall accuracy in detection of significant proteinuria (> 1 g/24-hour urine) in PE.
Conclusions: The P/C ratio of 1.35 ± 2.54 had 94.4% sensitivity, 94.9% specificity, 97.1% PPV, 90.2% NPV, and 94.5% overall accuracy in detection of significant proteinuria (> 1 g/24-hour urine) in PE. This study suggests the use of P/C ratio as an alternative to 24-hour urine protein to detect significant proteinuria in PE.
Keywords
protein/creatinine ratio; 24-hour urine; protein; preeclampsia (PE)
About this articleTitle
Protein/creatinine ratio versus 24-hours urine protein in preeclampsia
Journal
Issue
Article type
Research paper
Pages
975-979
Published online
2022-02-08
Page views
2557
Article views/downloads
850
DOI
10.5603/GP.a2021.0233
Pubmed
Bibliographic record
Ginekol Pol 2022;93(12):975-979.
Keywords
protein/creatinine ratio
24-hour urine
protein
preeclampsia (PE)
Authors
Ibrahim A. Abdelazim
Osama O. Amer
Svetlana Shikanova
Bakyt Karimova
References (17)- Osungbade KO, Ige OK. Public health perspectives of preeclampsia in developing countries: implication for health system strengthening. J Pregnancy. 2011; 2011: 481095.
- Wallis AB, Saftlas AF, Hsia J, et al. Secular trends in the rates of preeclampsia, eclampsia, and gestational hypertension, United States, 1987-2004. Am J Hypertens. 2008; 21(5): 521–526.
- Ananth CV, Basso O. Impact of pregnancy-induced hypertension on stillbirth and neonatal mortality. Epidemiology. 2010; 21(1): 118–123.
- Famurewa AC, Ugwuja EI, Ikaraoha CI. Comparison of serum calcium and magnesium between preeclamptic and normotensive pregnant Nigerian women in Abakaliki, Nigeria. Annals of Medical and Health Sciences Research. 2016; 6(1): 33.
- Ngwenya S. Severe preeclampsia and eclampsia: incidence, complications, and perinatal outcomes at a low-resource setting, Mpilo Central Hospital, Bulawayo, Zimbabwe. Int J Womens Health. 2017; 9: 353–357.
- Demirci O, Kumru P, Arınkan A, et al. Spot protein/creatinine ratio in preeclampsia as an alternative for 24-hour urine protein. Balkan Med J. 2015; 32(1): 51–55.
- Keane W, Eknoyan G. Proteinuria, albuminuria, risk, assessment, detection, elimination (PARADE): A position paper of the National Kidney Foundation. American Journal of Kidney Diseases. 1999; 33(5): 1004–1010.
- Price CP, Newall RG, Boyd JC. Use of protein:creatinine ratio measurements on random urine samples for prediction of significant proteinuria: a systematic review. Clin Chem. 2005; 51(9): 1577–1586.
- Protein/Creatinine ratio versus 24-Hour urine protein in preeclampsia. http://www.ANZCTR.org.au/ACTRN12618001910291.aspx (30.12.2020).
- Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists’ task force on hypertension in pregnancy. Obstet Gynecol. 2013; 122(5): 1122–1131.
- Farghali M, Abdelazim I, Abdelrazek K. Delayed second twin delivery: benefits and risks. J Matern Fetal Neonatal Med. 2019; 32(10): 1626–1632.
- Tranquilli AL, Brown MA, Zeeman GG, et al. The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Pregnancy Hypertens. 2013; 3(1): 44–47.
- Abdelazim IA, Bekmukhambetov Y, Aringazina R, et al. The outcome of hypertensive disorders with pregnancy. J Family Med Prim Care. 2020; 9(3): 1678–1683.
- Shreya G, Pranathi L, Kavitha V, et al. Comparison of spot urine protein-creatinine ratio with 24-hour urine protein excretion in women with preeclampsia. International Journal of Integrative Medical Sciences. 2015; 2(1): 55–59.
- Wheeler TL, Blackhurst DW, Dellinger EH, et al. Usage of spot urine protein to creatinine ratios in the evaluation of preeclampsia. Am J Obstet Gynecol. 2007; 196(5): 465.e1–465.e4.
- Morris RK, Riley RD, Doug M, et al. Diagnostic accuracy of spot urinary protein and albumin to creatinine ratios for detection of significant proteinuria or adverse pregnancy outcome in patients with suspected pre-eclampsia: systematic review and meta-analysis. BMJ. 2012; 345: e4342.
- Lezaic V, Ristic S, Dopsaj V, et al. Is morning urinary protein-to-creatinine ratio a reliable estimator of 24-hour proteinuria in patients with kidney diseases? Srpski arhiv za celokupno lekarstvo. 2010; 138(11-12): 726–731.
