Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio.
OBJECTIVE
Evaluate the value of random urinary protein-creatinine (PrCr) and calcium-creatinine (CaCr) ratios to predict 24-h proteinuria in hypertensive pregnancies.


METHODS
Spot urine samples were collected before routine 24-h urine collections from consecutive pregnant women with hypertension (n=83). Reliability of spot urinary PrCr and CaCr to detect significant proteinuria (>or=300 mg/day) using 24-h urine protein as 'gold-standard' was assessed by receiver-operating characteristic (ROC) curve.


RESULTS
Fifty-one patients (61.4%) had significant proteinuria (45 pre-eclampsia, 5 superimposed pre-eclampsia, 1 renal hypertension). Area under ROC curve to predict proteinuria was 0.82 (95% confidence interval (CI) 0.73 to 0.92, P<0.001) for PrCr and 0.55 (95% CI 0.43 to 0.68, P=0.2) for CaCr. A cutoff value of >0.19 for PrCr best predicted significant proteinuria with sensitivity, specificity, positive and negative predictive values and likelihood ratios (positive and negative), respectively, of 80.4, 68.8, 80.4, 68.8%, 2.57 and 3.51.


CONCLUSIONS
Spot urinary PrCr predicts total urinary protein excretion in hypertensive pregnancies.
Rizk
D E E
DE
Department of Obstetrics and Gynecology, United Arab Emirates University, Al-Ain, UAE. rizk.diaa@uaeu.ac.ae
Agarwal
M M
MM
Pathan
J Y
JY
Obineche
E N
EN
D000293:Adolescent; D000328:Adult; D002118:Calcium / Q000652:urine*; D015331:Cohort Studies; D003404:Creatinine / Q000652:urine*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis* / Q000652:urine; D006977:Hypertension, Renal / Q000175:diagnosis / Q000652:urine; D008875:Middle Aged; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000652:urine; D011237:Predictive Value of Tests; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis* / Q000652:urine; D012372:ROC Curve; D014479:United Arab Emirates
D003404:Creatinine; D002118:Calcium