Urine Protein to Creatinine Ratio for the Assessment of Bevacizumab-Associated Proteinuria in Patients with Gynecologic Cancers: A Diagnostic and Quality Improvement Study
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View abstract on PubMed
Summary
This summary is machine-generated.The urine protein to creatinine ratio (UPCR) offers a more accurate and cost-effective method for detecting proteinuria in gynecologic cancer patients treated with bevacizumab, reducing the need for cumbersome 24-hour urine collections.
Area Of Science
- Nephrology
- Oncology
- Clinical Chemistry
Background
- Proteinuria is a frequent adverse event associated with bevacizumab therapy in gynecologic cancer patients.
- Current diagnostic methods, such as 24-hour urine collection, are inconvenient for patients.
Purpose Of The Study
- To evaluate the diagnostic accuracy and cost-effectiveness of urine screening methods for proteinuria in gynecologic cancer patients receiving bevacizumab.
- To compare the urine protein to creatinine ratio (UPCR) and urine albumin to creatinine ratio (UACR) against the gold standard of 24-hour urine protein (TP) collection.
Main Methods
- Prospective assessment of 129 urine samples from 36 gynecologic cancer patients treated with bevacizumab.
- Measurement of urine dipstick (UD), microalbumin, total protein, and creatinine.
- Calculation of UACR and UPCR, adjusted using Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations.
- Correlation analysis with 24-hour urine TP and cost-effectiveness analysis.
Main Results
- UPCR demonstrated higher sensitivity (0.71) and specificity (0.88) compared to UD (sensitivity 0.56, specificity 0.97 for UACR).
- Both UACR (r=0.75) and UPCR (r=0.79) showed strong correlations with 24-hour TP, while UD showed a fair correlation (r=0.35).
- UPCR analysis indicated cost savings by potentially avoiding unnecessary 24-hour urine tests.
Conclusions
- The UPCR is a reliable, accurate, and cost-effective alternative to 24-hour urine collection for monitoring bevacizumab-induced proteinuria.
- Implementing UPCR can improve diagnostic efficiency, reduce patient burden, and lower healthcare costs.
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