Comparison of Measurement of 24-Hour Urine Protein Excretion Versus Random Urine Protein-Creatinine Ratio in Pregnant Woman with Pre-eclampsia


ABSTRACT:BACK GROUND: Measurement of protein excretion in a 24-hour urine collection has been the long-standing gold-standard but time consuming test for the quantitative evaluation of proteinuria induced by preeclampsia. An alternative method is the measurement of protein- creatinine ratio in a spot urine sample, which provides a more convenient and rapid method to assess protein excretion.OBJECTIVE:To assess the correlation between the spot urine protein- creatinine ratio and 24-hour urine protein excretion in women with preeclampsia and to use the urine protein- creatinine ratio as alternative to time-consuming 24-hour urine protein collection. Study design: A cross sectional study.Setting: Department of Obstetrics and Gynecology at Al-Yarmouk Teaching Hospital for a period of one year from Jan. 2013 to Jan. 2014PATIENTSAND METHODS:Eighty three singleton pregnant women suffering from pre-eclampsia with gestational age between 28 to 39 weeks were selected to participate in the study. They were divided into two groups: 61pregnant women with mild to moderate pre-eclampsia and 22 with severe pre-eclampsia.These women were prospectively studied for proteinuria. Urine protein- creatinine ratio was determined in a spot mid-stream urine sample, and the amount of protein excretion was measured in 24-hour urine collected on the subsequent day. The correlation between the two tests was assessed.RESULTS : Diagnostic value of protein/creatinine ratio was expressed in terms of specificity and sensitivity.There was significant correlation between protein/ creatinine ratio in a single void urine with 24 hr. urine collection for protein as the P value was (0.0001), The ROC curve analysis showed an area under the curve of (0.879), indicating that the urine protein: creatinine ratio can detect severe proteinuria at a cutoff point of 4.2 with a sensitivity of (81.8%) and specificity of (85.2%). CONCLUSION: There is a significant correlation between the spot urine protein/ creatinine ratio and 24-hour urine protein excretion in women with preeclampsia.