Protein/Creatinine Ratio in Random Urine Sample for Quantitation of Proteinuria Compared with 24 Hour Urine Collection in Patients with Pre-Eclampsia (original) (raw)
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Australian and New …, 2006
Background: Because of the importance of pre-eclampsia and proteinuria in pregnancy, a faster and simpler diagnostic method is needed. Aim: To compare random urine protein to creatinine ratio (p:c ratio) with 24-h urine protein excretion rate in pregnant women with a suspicion of pre-eclampsia. Methods: The study was conducted on 100 pregnant women with gestational ages of ≥ 20 weeks; 50 patients were suspected of having pre-eclampsia and 50 were healthy pregnant women. A random urine sample for p:c ratio determination and a 24-h urine sample for protein measurement were obtained. Results: All women suspected of having pre-eclampsia had significant proteinuria. The single-voided p:c ratio demonstrated a sensitivity of 94% with a specificity of 96% at the cutoff ≥ 0.2 mg/mg. There was strong correlation between the two methods in this group (r = 0.70, P < 0.001, R 2 = 49%). Using the same cutoff in the pregnant women who were not thought to have pre-eclampsia, the sensitivity of the test (p:c ratio) was 29% and the specificity was 87%. Pearson's correlation coefficient was 26 (P < 0.06). Negative predictive value and positive predictive value were 34 and 83%, respectively. Conclusion: There is a strong correlation between 24-h urine protein excretion and single-voided urine p:c ratio in women suspected of having pre-eclampsia. A single-voided p:c ratio of ≥ 0.2 mg/mg is highly predictive for significant proteinuria. However, this test was not found to be a reasonable alternative to 24-h urine collection; and it must be followed by 24-h urine collection in a clinically suspect patient with a p:c ratio of < 0.2 mg/mg.
Journal of Evidence Based Medicine and Healthcare, 2015
Hypertensive disorders complicating pregnancy are common and form one of the deadly triad along with haemorrhage and infection that results in much of the maternal morbidity and mortality related to pregnancy. Proteinuria is essential for the diagnosis of preeclampsia. As the Proteinuria increases, the likelihood of complications also increases and hence a rapid and accurate detection and quantization of Proteinuria is essential for the management of hypertensive pregnant women. The protein creatinine ratio in a single urine specimen has been used for the rapid and accurate detection of proteinuria in hypertensive pregnant women as it avoids collection errors and gives physiologically more relevant information. OBJECTIVES OF THE STUDY: To study the clinical profile of preeclampsia patients. To assess the degree of Proteinuria by 24 hour urine protein and spot urine protein Creatinine ratio in the study population To study if the spot urine protein and creatinine ratio will provide accurate quantification of proteinuria in hypertensive pregnant women. MATERIALS AND METHODS: This was observational study it was conducted in King George Hospital for a period of one year & 60 patients were included for the study. RESULTS: In the present study: spot urine p/c ratio sensitivity 100%, specificity 66.67%, and positive predictive value of 98.27% added. CONCLUSION: quantization of proteinuria, when properly interpreted, can provide valuable information.
Spot Protein/ creatinine ratio in preeclampsia as an alternative for 24-hour urine protein
Balkan Medical Journal, 2015
Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is timeconsuming. As an alternative, random spot sampling for a urine protein to creatinine (P/C) ratio has been investigated. Aims: The aim of the study was to determine the diagnostic accuracy of the protein to creatinine ratio (P/C) compared with 24-hour urine collection for the detection of remarkable proteinuria and to evaluate the P/C ratio for different proteinuria ranges in patients with preeclampsia. Study Design: Case-control study. Methods: Two hundred and eleven pregnant women who met the criteria of preeclampsia comprised the study group and fifty three pregnant women were taken as the control group. Spot urine specimens for measuring P/C ratio were obtained taken immediately before 24-hour urine collection. The correlation between the P/C ratio in the spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test. Results: It was found a good positive correlation between the P/C ratio and 24-hour protein excretion, with a correlation coefficient (r) of 0.758. The best cutoff which gave the maximum area under the curve was 0.45 for 300 mg, 0.9 for 1000 mg, 1.16 for 2000 mg, 1.49 for 3000 mg, 2.28 for 4000 mg and 2.63 for 5000 mg per 24h. A P/C ratio above 0.9 strongly predicts significant proteinuria for more than 1 gram (AUC 0.97, 95% CI: 0.94-0.99 and sensitivity, specificity, positive and negative predictive value of 91%, 95.4%, 95.2%, and 91.2%, respectively). Conclusion: The P/C ratio can be used as a screening test as a good predictor for remarkable proteinuria. The P/C ratio seems to be highly predictive for diagnosis to detect proteinuria over one gram and it could be used as a rapid alternative test in preeclamptic patients not to delay implementation treatment.
Protein/Creatinine ratio versus 24-hours urine protein in preeclampsia
Ginekologia Polska, 2022
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 wellbeing 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 protocol, and to excluded preexisting 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. 1 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.
Critical analysis of proteinuria estimation methods in pre-eclampsia: A main research article
IP Innovative Publication Pvt. Ltd., 2017
Purpose of the study: The gold standard 24-hour urine collection method for protein estimation is inconvenient and is associated with a delay in laboratory analysis. This study was undertaken to analyse the salphosalicylic acid test, urine dip stick test, urine protein to creatinine ratio with 24-hour urine protein estimation in pre-eclampsia cases. Materials and Method: This is a comparative study and consists of a single group of 240 subjects. This study was conducted in the Department of Obstetrics and Gynecology in collaboration with the. The subjects included 240 pre-eclampsia women. A first voided morning sample was obtained for sulphosalicylic acid test, Dipstick test, urine protein and creatinine estimation, urine culture and Subsequent urine samples were collected for the 24-hour urine protein estimation. Main findings: For significant proteinuria sulphosalicylic acid test with 1+ proteinuria has sensitivity, specificity, PPV, NPV of 59%,48%,39%,67% where as 2+ has 44%, 88%, 75% and 67% respectively, dipstick test with 1+ proteinuria has sensitivity, specificity, PPV, NPV of 71%, 52%, 54%,70% where as 2+ has 49%, 87%, 75% and 69% respectively. The spot urine protein to creatinine ratio and 24-hour urine protein were significantly correlated (r=0.98; P<0.0001). The cutoff value for the protein to creatinine ratio as an indicator of protein excretion ≥300 mg/day was 0.285. The sensitivity, specificity PPV and NPV were 100%, 99.02%, 100% and 99% respectively. Conclusion: The spot urine protein to creatinine ratio is a better method for estimation of proteinuria in pre-eclampsia.
To evaluate the diagnostic accuracy of the first 4-hour urinary protein -creatinine ratio for prediction of the significant proteinuria in preeclampsia Study design: Diagnostic test Subjects: One hundred and sixty-four pregnant women who were initially diagnosed with hypertensive disorder and hospitalized in the obstetric ward and labor room at Bangkok Metropolitan Administration Medical Collage and Vajira Hospital between July 2005 and April 2006. Material and Method: Urine samples were collected within 24 hours in two consecutive periods: the first 4 hours and the next 20 hours. The urine volume, urine protein and creatinine concentration were separately measured and the first 4-hour urinary protein -creatinine ratio were calculated. With the use of a protein level > 300 mg in 24 hours urine collection as the gold standard, the sensitivity and specificity of the first 4-hour urinary protein-creatinine ratio for diagnosis of significant proteinuria were determined with cutoffs range. Results: One hundred and sixty four patients were recruited for this study including 112 patients (68.3%) who had preeclampsia. The first 4-hour urinary protein-creatinine ratio was most accurate for diagnosis of preeclampsia is 0.30 with 81% sensitivity, 88% specificity, PPV of 93%, and NPV of 71%. Conclusion: The first 4-hour urinary protein-creatinine ratio at 0.3 is the most accurate value for diagnosis of significant proteinuria in preeclampsia
IP innovative publication pvt ltd, 2020
Introduction: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is time-consuming. As an alternative, spot sampling for a urine protein to creatinine ratio (PCR) ratio has been investigated. Aim & Objectives: To determine the accuracy of the spot protein- creatinine ratio in comparison with 24 hours urine collection for detection of proteinuria in pre- eclamptic patients. Materials and Methods: A hospital based prospective study was conducted with 120 patients to assess the quantification of proteinuria in preeclamptic patient and comparing the two methods i.e. 24-hr urine protein levels and random protein creatinine ratio conducted at tertiary care centre. Results: There was a good positive statistical correlation between 24-hour total urinary protein level and spot protein: creatinine ratio with a correlation coefficient (r) of 0.769.Conclusion: Random and spot urine protein creatinine ratio can predict with high accuracy the amount of 24- hour urine protein excretion. The urine PCR is reliable, relatively faster and accurate for proteinuria and can correlate well with 24-hour urinary protein excretion which is gold standard.
IP innovative publication pvt. ltd, 2019
Introduction: Estimation of urinary excretion of protein is done by the standard method of collection of urine over 24- hours and the test sample is taken from this collection. Because of its technical difficulty there is the necessity to use quick, convenient and reliable method which is well correlates with 24-h urine protein. Aim: This study is carried out to compare the dipstick method and spot urine protein creatinine ratio (UPCR) with that of 24-h urine protein (24HUP) and also to determine the role of proteinuria in predicting the pregnancy outcome in preeclamptic patients. Materials and Methods: We conducted this prospective analytical study in 209 antenatal women in whom 52 were with gestational hypertension and 157 were with preeclampsia. Pearson’s correlation coefficient revealed the strength of correlation while the p value less than 0.05 was considered to be statistically significant. Receiver-operator curve (ROC) was plotted to find the cut-off value of UPCR and dipstick in detecting significant proteinuria (≥300mg/day). Results: The value of UPCR strongly correlated with 24-h urine protein (r=0.941, p<0.001). The cut-off value of 0.25 by UPCR method was considered as significant proteinuria. A strong positive correlation was found between 24HUP test and dipstick test (r=0.759, p<0.001) results with a cut-off value of 1.5 to detect significant proteinuria. Conclusions: Spot UPCR can be used as a rapid and reliable alternative method to 24-h urine protein in preeclamptic patients.
Journal of Drug Delivery and Therapeutics, 2021
Background: Preeclampsia is characterized by hypertension and proteinuria with the onset after 20 weeks of gestation. Globally 14.5% of maternal death is due to preeclampsia with fetal complications. National Record of Family Health Division Nepal shows prevalence rate of preeclampsia as 8.5%. The gold standard 24 hours urine protein evaluation test is time consuming for the diagnosis of preeclampsia and can increase complications to mother and fetus. Instant diagnosis and prompt management is needed. Objective of this study was to determine the accuracy of urinary protein/creatinine (P/C) ratio test and correlate random urinary (P/C) ratio with twenty-four hours urinary protein in detecting preeclampsia. Methods: A cross sectional study was carried out conveniently selecting 130 samples of preeclampsia from Obstetrics and Gynaecology Department of National Medical College Teaching Hospital, Birgunj, Nepal. Out of 130 samples all met the inclusion criteria. Both twenty-four hours ur...