A Comparison of Spot Urine Protein-Creatinine Ratio vs. 24 hours Urinary Protein Excretion in Women with Pre Eclampsia (Pages 67-72)

Shazia Majid Khan, Tahira Parven and Saima Zulfiqar

Department of Obstetrics and Gynecology, Unit I, Sheikh Zayed Medical College/Hospital, Rahim Yar Khan, Pakistan

DOI: http://dx.doi.org/10.14205/2309-4400.2014.02.02.1

Abstract: Objective: To evaluate diagnostic accuracy of spot urine protein-creatinine ratio for the diagnosis of proteinuria among patients with preeclampsia taking 24 hours urinary protein concentration > 300 mg/24hrs as gold standard.

Study Design: This was a cross sectional study.

Introduction: Preeclampsia can lead to significant morbidity and mortality. One of the important characteristic of diagnosis of preeclampsia is proteinuria. Gold standard for detection of significant proteinuria among these patients is 24 hours urinary proteins level (>300 milli grams). However, spot urinary protein-creatinine ratio can also detect proteinuria and save patients from botheration for collection of 24 hours urine. Previously, variable sensitivities, specificities and diagnostic accuracy of spot urinary protein-creatinine ratio had been calculated. So, this study was designed to determine diagnostic accuracy of spot urinary protein-creatinine ratio.

Methods: 551 patients with preeclampsia were included. All patients had spot urinary protein-creatinine ratio (>0.3 was cutoff for proteinuria). All patients had 24 hours urinary protein test (>300 grams cutoff for proteinuria) as gold standard. Diagnostic accuracy of urinary protein-creatinine ratio was detected by determining sensitivity, specificity and accuracy.

Results: Sensitivity, specificity, and accuracy of spot urinary protein-creatinine ratio were 95.8%, 94.2% and 91.6%, respectively.

Conclusions: Due to its high sensitivity, specificity and diagnostic accuracy, urinary protein-creatinine ratio is a reliable test for diagnosing proteinuria among patients with preeclampsia.

Keywords: Preeclampsia, spot urinary protein-creatinine ratio, 24 hours urinary protein, diagnostic accuracy.