Comparison of random urine protein/creatinine ratio with 24-hour urine protein in suspected pre-eclampsia

Lily Olayinka, Emily Garnett, Brian Burnett, Sridevi Devaraj, Lily Olayinka, Emily Garnett, Brian Burnett, Sridevi Devaraj

Abstract

Introduction: Proteinuria is one of the classical criteria for the diagnosis of pre-eclampsia. The gold standard remains the measurement of 24-h urine protein which is time consuming and prone to preanalytical errors. Random urine protein creatinine ratio (UPCR) is endorsed by clinical practice guidelines as a faster alternative. The aim of this study was to evaluate the correlation between the 24-h urine protein excretion and UPCR in the identification of proteinuria in suspected preeclamptic patients.

Method: A total of 51 women with suspected pre-eclampsia from the maternal fetal clinic of our institution were retrospectively studied. The correlation between the UPCR in random urine samples and protein excretion in the 24-h urine collection was determined by Deming Regression analysis and Pearson correlation on EP evaluator and SPSS respectively.

Result: There was a significant positive correlation between the numerical values obtained by 24-h urine protein and the UPCR (R = 0.88, P < 0.001). Concordance analysis showed 81.1% positive agreement for proteinuria between methods (>300 mg/24hr and >0.3) and 71.4% negative agreement. The clinical sensitivity and specificity of the UPCR was 74% and 69% respectively.

Conclusion: Overall, UPCR was well correlated with 24-h urine protein and could be an effective and compliant screening tool to indicate proteinuria in preeclamptic patients.

Keywords: 24-H urine protein excretion; Pre-eclampsia; Protein-creatinine-ratio; Proteinuria.

Conflict of interest statement

Lily Olayinka: None. Emily Garnett: None. Brain Burnett: None. Sridevi Devaraj: None.

© 2023 The Authors.

Figures

Fig. 1
Fig. 1
Scatter plot showing correlation between 24hr urine protein and UPCR (protein creatinine ratio) at 24 h urine protein excretion ≥0.3 mg/24hr using Deming regression. R = 0.87, slope = 1.1, Intercept = 0.1. Blue dotted line indicates the decision limit of >0.3 mg/24hr. (For interpretation of the references to color in this figure legend, the reader is referred to the Web version of this article.)

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Source: PubMed

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