Spot Urine Albumin to Creatinine Ratio versus Urine Protein to Creatinine Ratio for the Diagnosis of Proteinuria in Pregnancy

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Published: Dec 29, 2017
DOI: https://doi.org/10.14456/tjog.2017.33

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Paroon Sanoonrat
Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand
Nattinee Srisantiroj
Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand
Marut Yanaranop
Department of Obstetrics and Gynecology, Rajavithi Hospital, Bangkok, Thailand

Abstract

Objectives: To evaluate the correlation of the spot urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR) with 24-hour urine protein (UP-24) collection and to explore the diagnostic performances of these parameters for detecting significant proteinuria in pregnancy
Materials and Methods: This cross-sectional study was conducted on pregnant women at gestational ages 20-41 weeks who had clinically suspected proteinuria and were prospectively enrolled from November 2015 to April 2016. Random urine samples for UACR, UPCR and 24-hour urine collection for protein and creatinine were examined.
Results: A total of 115 pregnant women were evaluated. Using UP-24 as the reference standard, significant proteinuria was identified in 39 cases (33.9%). UACR had a higher level of correlation than UPCR with UP-24 (r = 0.884 and 0.834, respectively). The areas under the receiver characteristics curves (ROC-AUC) of UACR and UPCR were 96.6% (95%CI; 93.8-99.9) and 94.5% (95%CI; 90.4-98.6), respectively. The diagnostic threshold of UACR for significant proteinuria was 42 mg/g. (94.9% sensitivity and 86.8% specificity), whereas the UPCR cutoff value was 0.26, (87.2% sensitivity and 90.8% specificity). Predicted UP-24 using spot UACR adjusted by maternal age had the highest ROC-AUC of 97.4% (95%CI; 95.1-99.6), with a sensitivity of 94.9% and a specificity of 90.8%.
Conclusion: Spot UACR showed better correlation with UP-24 than UPCR. Spot UACR adjusted for maternal age, yielded a good diagnostic performance that was not associated with the time of urine collection and underlying diseases.


Keywords: preeclampsia, urine albumin to creatinine ratio, urine protein to creatinine ratio, proteinuria.

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How to Cite
(1)
Sanoonrat, P.; Srisantiroj, N.; Yanaranop, M. Spot Urine Albumin to Creatinine Ratio Versus Urine Protein to Creatinine Ratio for the Diagnosis of Proteinuria in Pregnancy. Thai J Obstet Gynaecol 2017, 25, 249-258.
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VOL. 25, NO. 4: (October - December 2017)
Section
Original Article

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