The accuracy of spot urine protein-to-creatinine ratio in diagnosis or exclusion of signifi cant proteinuria in pre-eclampsia

Abstract

Background: Proteinuria is a major component of preeclampsia. Urine protein measurement after 24-hour urine collection is the traditional standard method for the detection of proteinuria. It is time- consuming and costly. Prompt diagnosis of preeclampsia is necessary to prevent fatal maternal and foetal complications. As an alternative, random spot urine protein to creatinine ratio (PCR) has been investigated.

Objectives: To assess if spot urine protein-creatinine ratio can be used as an alternative diagnostic test to the traditional quantitative 24-hour urine protein excretion for signifi cant proteinuria in pre-eclampsia.

Methods:

Study Design: Case-control study. Prospective cross-sectional study was conducted on pregnant women with equal to or more than 20 weeks’ gestation, admitted for pre-eclampsia work-up at Pelonomi Regional Hospital from July 2020 to December 2020.Results: In total, 99 patients were included. There was a high correlation rate (r=0.74, P<0.001.) between the two tests. The area under the curve (ROC) was 0.8506. The optimal PCR cut-off found was 30mg/mmol (sensitivity=81.45%, specifi city=77.7 8%). The PPV was 81,48 % and the NPV was 77,78 %. The LR+ was 3.67 and LR- was 0.24.

Conclusion: The random urine spot protein-creatinine ratio is a good alternative diagnostic test for signifi cant proteinuria in pre-eclampsia because of its high correlation rate (r=0.74, P<0.001.) with 24-hour urine protein. It is a cost-effective, easy, non-invasive, and faster test. This will reduce the patient’s stay in hospital, prevent complications associated with pre-eclampsia and will shorten diagnosis-treatment interval.