Comparison of Random Urine Protein/Creatinine Ratio With 24-Hour Urine Protein in Suspected Pre-Eclampsia

Authors

Lily Olayinka
Emily Garnett
Brian Burnett
Sridevi Devaraj

Publication Date

8-1-2023

Journal

Practical Laboratory Medicine

DOI

10.1016/j.plabm.2023.e00316

PMID

37649542

PMCID

PMC10462489

PubMedCentral® Posted Date

6-21-2023

PubMedCentral® Full Text Version

Post-print

Published Open-Access

yes

Keywords

Pre-eclampsia, Protein-creatinine-ratio, Proteinuria, 24-H urine protein excretion

Abstract

INTRODUCTION: Proteinuria is one of the classical criteria for the diagnosis of pre-eclampsia. The gold standard remains the measurement of 24-h urine protein which is time consuming and prone to preanalytical errors. Random urine protein creatinine ratio (UPCR) is endorsed by clinical practice guidelines as a faster alternative. The aim of this study was to evaluate the correlation between the 24-h urine protein excretion and UPCR in the identification of proteinuria in suspected preeclamptic patients.

METHOD: A total of 51 women with suspected pre-eclampsia from the maternal fetal clinic of our institution were retrospectively studied. The correlation between the UPCR in random urine samples and protein excretion in the 24-h urine collection was determined by Deming Regression analysis and Pearson correlation on EP evaluator and SPSS respectively.

RESULT: There was a significant positive correlation between the numerical values obtained by 24-h urine protein and the UPCR (R = 0.88, P < 0.001). Concordance analysis showed 81.1% positive agreement for proteinuria between methods (>300 mg/24hr and >0.3) and 71.4% negative agreement. The clinical sensitivity and specificity of the UPCR was 74% and 69% respectively.

CONCLUSION: Overall, UPCR was well correlated with 24-h urine protein and could be an effective and compliant screening tool to indicate proteinuria in preeclamptic patients.