Abstract
OBJECTIVE: To determine diagnostic accuracy of spot urine protein to
creatinine ratio (PCR) for estimation of significant proteinuria in patients of
preeclampsia based on 24-hour urine protein.
METHODS: This cross-sectional validation study was conducted at Gynae B
unit, Lady Reading Hospital, Peshawar from July 2014 to December 2014. Out
of 253 patients, 222 women were finally enrolled as per inclusion and exclusion
criteria by using non-probability convenient sampling technique. After taking
proper history and calculating period of gestation, blood pressure was
measured using standard sphygmomanometer while urinary protein by urine
dipsticks. Following standard protocol, urine was collected for 24 hours
followed by spot midstream urine. Samples were analyzed for urine protein and
creatinine. 24 hours urinary protein level ≥300 mg/day and spot urine PCR was
≥3 mg/mmol was considered significant proteinuria. SPSS v 16.0 was used a
statistical instrument.
RESULTS: Out of 222 patients with preeclampsia, 24-hours urinary protein
level estimation was ≥300 mg/day in 179 (80.6%) cases and <300 mg/day in 43
(19.4%) cases. Spot urine PCR was ≥3 mg/mmol in 175 (78.8%) cases and <3
mg/mmol in 47 (21.2%) cases. The sensitivity, specificity, positive predictive
value (PPV), negative predictive value (NPV) and diagnostic accuracy of spot
urine PCR against 24-hours urinary protein level estimation was 95.5%,
90.6%, 97.7% 82.9% and 94.5% respectively.
CONCLUSION: In our study, spot urinary protein/ creatinine ratio shows a
high sensitivity, specificity, PPV, and NPV (at a cut off value >0.3 mg/mmol). This
test can be regarded as a reliable investigation among pre-eclamptic patients.
Saira Shagufta, Rubina Akhtar, Sanodia Afridi. (2019) DIAGNOSTIC ACCURACY OF SPOT URINE PROTEIN TO CREATININE RATIO FOR ESTIMATION OF SIGNIFICANT PROTEINURIA IN PATIENTS OF PREECLAMPSIA, KHYBER MEDICAL UNIVERSITY JOURNAL, Volume 11, Issue 4.
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