title: A random protein-creatinine ratio accurately predicts baseline proteinuria in early pregnancy.
abstract: OBJECTIVE
  Data surrounding the use of a random urine protein:creatinine ratio (PCR) in the diagnosis of preeclampsia is conflicting. We sought to determine whether PCR in early pregnancy can replace the 24-hour urine collection as the primary screening test in patients at risk for baseline proteinuria.
  
  
  METHODS
  Women requiring a baseline evaluation for proteinuria supplied a urine sample the morning after their 24-hour collection. The PCR was analyzed as a predictor of significant proteinuria (≥150 mg). A regression equation to estimate the 24-hour protein value from the PCR was then developed.
  
  
  RESULTS
  Sixty of 135 subjects enrolled completed the study. The median 24-hour urine protein and PCR were 90 mg (IQR: 50-145) and 0.063 (IQR: 0.039-0.083), respectively. Fifteen patients (25%) had significant proteinuria. PCR was strongly correlated with the 24-hour protein value (r = 0.99, p < 0.001) and highly predictive of significant proteinuria (AUC = 0.86). A PCR cut-point of 0.079 yielded a sensitivity of 93.3% and a specificity of 57.8%. The resulting regression equation [total protein = 46.5 + 904.2*PCR] accurately estimates the actual 24-hour protein (95% CI: ±88 mg).
  
  
  CONCLUSIONS
  A random urine PCR accurately estimates the 24-hour protein excretion in the first half of pregnancy and can be used as the primary screening test for baseline proteinuria in at-risk patients.
authors.affiliation: Maternal and Child Health Research Program, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine , Philadelphia, PA , USA and.
authors.forename: Adi
authors.initials: A
authors.lastname: Hirshberg
authors.forename: Jennifer
authors.initials: J
authors.lastname: Draper
authors.forename: Cara
authors.initials: C
authors.lastname: Curley
authors.forename: Mary D
authors.initials: MD
authors.lastname: Sammel
authors.forename: Nadav
authors.initials: N
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D003404:Creatinine / Q000652:urine*; D005260:Female; D005865:Gestational Age; D006801:Humans; D011225:Pre-Eclampsia / Q000175:diagnosis* / Q000652:urine; D011247:Pregnancy / Q000652:urine; D011248:Pregnancy Complications / Q000175:diagnosis / Q000652:urine; D011261:Pregnancy Trimester, First / Q000652:urine; D011506:Proteins / Q000378:metabolism; D011507:Proteinuria / Q000175:diagnosis*; D016482:Urinalysis / Q000379:methods*; D055815:Young Adult
chemical_list: D011506:Proteins; D003404:Creatinine
keywords: 24-hour urine; PCR; baseline proteinuria; preeclampsia