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Predicting proteinuria in hypertensive pregnancies with urinary protein-creatinine or calcium-creatinine ratio
D E E Rizk1, M M Agarwal, J Y Pathan
1Department of Obstetrics and Gynecology, United Arab Emirates University, Al-Ain, UAE. rizk.diaa@uaeu.ac.ae
Objective:
Evaluate the value of random urinary protein-creatinine (PrCr) and calcium-creatinine (CaCr) ratios to predict 24-h proteinuria in hypertensive pregnancies.
Study Design:
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.
Conclusion:
Spot urinary PrCr predicts total urinary protein excretion in hypertensive pregnancies.
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