Assessment of Protein:Creatinine Ratio versus 24-Hour Urine Protein in the Diagnosis of Preeclampsia

Gynecol Obstet Invest. 2016;81(1):78-83. doi: 10.1159/000381773. Epub 2015 Jun 3.

Abstract

Background/aims: Current evidence has tried to extrapolate the use of the protein:creatinine ratio (PCR) in a single urine sample as a rapid diagnostic tool for preeclampsia (PE). The present study addresses the effectiveness of the PCR in the differential diagnosis of the pregnancy hypertensive disorder (PHD).

Methods: This is a prospective study conducted on patients admitted during 1 year with a diagnosis of PHD. These pregnant women were assessed for the correlation between the 24-hour test and the PCR to detect significant proteinuria. A ROC curve was made to determine the PCR cutoff value that would offer the best positive predictive value (PPV) as an early predictor of global and severe PE.

Results: A total of 72 patients with 24-hour proteinuria and PCR were studied (49 with PE). A significant correlation between the quick and the deferred sampling was observed (r = 0.60; p < 0.001). The ROC analysis showed a PCR of 0.36 as the best cutoff value for the diagnosis of global PE (PPV 96.4%; false-positive rate 4.4%; AUC 0.8802) and a cutoff value of 4.58 (sensitivity: 100%; PPV 87.5%; false-positive rate 3.5%; AUC 0.9805) as the best cutoff for the diagnosis of severe proteinuria.

Conclusions: PCR proved to be an effective test for the differential diagnosis of PHS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Creatinine / urine*
  • Diagnosis, Differential
  • Female
  • Humans
  • Pre-Eclampsia / urine*
  • Predictive Value of Tests
  • Pregnancy
  • Prospective Studies
  • Proteinuria / urine*
  • Sensitivity and Specificity
  • Urinalysis

Substances

  • Creatinine