Random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with preeclampsia.
OBJECTIVE
To evaluate the accuracy of random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with suspected preeclampsia.


METHODS
A prospective study was conducted in hospitalized pregnant women with a suspicion of preeclampsia. Random mid-stream urine specimens were obtained for protein-to-creatinine ratio determination, and then participants were instructed to collect 24-h urine samples for protein measurement. With the criterion of 24-h proteinuria of at least 300 mg as a significant proteinuria, the sensitivity and specificity of a random urinary protein-to-creatinine ratio of > or = 0.19 for prediction of significant proteinuria were analyzed and a receiver operating characteristic curve was constructed to determine the optimal cutoff value.


RESULTS
Forty-two patients completed the study. Sixty-nine percent of the study population had significant proteinuria. A cutoff of 0.19 demonstrated a sensitivity of 100% and a specificity of 53.8%. A ratio below 0.22 could rule out a significant proteinuria. The optimal cutoff value is 0.25 which yielded sensitivity, specificity and accuracy of 96.6%, 92.3% and 95.2% respectively.


CONCLUSIONS
In hospitalized preeclamptic patients, the random urinary protein-to-creatinine ratio at a cutoff of > or = 0.25 revealed a highly accurate prediction of significant proteinuria and could be a more practical alternative for assessment of proteinuria.
Yamasmit
Waralak
W
Department of Obstetrics and Gynecology, Bangkok Metropolitan Administration Medical College and Vajira Hospital, Bangkok, Thailand.
Chaithongwongwatthana
Surasith
S
Charoenvidhya
Dhiraphongs
D
Uerpairojkit
Boonchai
B
Tolosa
Jorge
J
D000293:Adolescent; D000328:Adult; D000465:Algorithms; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine*; D005260:Female; D006801:Humans; D007297:Inpatients; D016017:Odds Ratio; D015143:Philadelphia; D011225:Pre-Eclampsia / Q000652:urine*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011446:Prospective Studies; D011507:Proteinuria / Q000652:urine*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013785:Thailand
D015415:Biomarkers; D003404:Creatinine