title: Spot protein/creatinine ratio in preeclampsia as an alternative for 24-hour urine protein.
abstract: BACKGROUND
  Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is time-consuming. As an alternative, random spot sampling for a urine protein to creatinine (P/C) ratio has been investigated.
  
  
  OBJECTIVE
  The aim of the study was to determine the diagnostic accuracy of the protein to creatinine ratio (P/C) compared with 24-hour urine collection for the detection of remarkable proteinuria and to evaluate the P/C ratio for different proteinuria ranges in patients with preeclampsia.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Two hundred and eleven pregnant women who met the criteria of preeclampsia comprised the study group and fifty three pregnant women were taken as the control group. Spot urine specimens for measuring P/C ratio were obtained taken immediately before 24-hour urine collection. The correlation between the P/C ratio in the spot urine samples and urinary protein excretion in the 24-hour collections was examined using the Spearman correlation test.
  
  
  RESULTS
  It was found a good positive correlation between the P/C ratio and 24-hour protein excretion, with a correlation coefficient (r) of 0.758. The best cut-off which gave the maximum area under the curve was 0.45 for 300 mg, 0.9 for 1000 mg, 1.16 for 2000 mg, 1.49 for 3000 mg, 2.28 for 4000 mg and 2.63 for 5000 mg per 24h. A P/C ratio above 0.9 strongly predicts significant proteinuria for more than 1 gram (AUC 0.97, 95% CI: 0.94-0.99 and sensitivity, specificity, positive and negative predictive value of 91%, 95.4%, 95.2%, and 91.2%, respectively).
  
  
  CONCLUSIONS
  The P/C ratio can be used as a screening test as a good predictor for remarkable proteinuria. The P/C ratio seems to be highly predictive for diagnosis to detect proteinuria over one gram and it could be used as a rapid alternative test in preeclamptic patients not to delay implementation treatment.
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Oya
authors.initials: O
authors.lastname: Demirci
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Pınar
authors.initials: P
authors.lastname: Kumru
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Arzu
authors.initials: A
authors.lastname: Arınkan
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Cem
authors.initials: C
authors.lastname: Ardıç
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Resul
authors.initials: R
authors.lastname: Arısoy
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Elif
authors.initials: E
authors.lastname: Tozkır
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Tandoğan
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Habibe
authors.initials: H
authors.lastname: Ayvacı
authors.affiliation: Department of Perinatology, Zeynep Kamil Gynecologic and Pediatric Training and Research Hospital, İstanbul, Turkey.
authors.forename: Ahmet S
authors.initials: AS
authors.lastname: Tuğrul
keywords: Preeclampsia; proteinuria; urine protein-creatinine ratio