Alternate evaluations of proteinuria in the gravid hypertensive patient

Frank Schubert, Mary P. Abernathy

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

OBJECTIVE: To determine if the 12-hour urine total protein value correlates with the 24-hour value and to evaluate the random protein:creatinine ratio as a predictor of significant proteinuria (≥ 300 mg/24 h) for use in diagnosing preeclampsia. STUDY DESIGN: The study population included 15 patients with hypertensive disorders of pregnancy. The patients' urine was collected over 24 hours in 2 12-hour aliquots. The urine volume, total protein and creatinine were measured. The patients' initial voids were collected and evaluated for random urine protein and creatinine and calculation of the protein:creatinine ratio. The protein:creatinine ratio and 12-hour results were compared to the 24-hour results using simple regression analysis. RESULTS: Of the 15 patients, 6 had no proteinuria, 5 had mild proteinuria, and 4 had severe proteinuria (60% with significant proteinuria). The 12-hour protein results correlated with the 24-hour results for patients with mild disease (p = 0.00007, first 12 hours, and p = 0.012, second 12 hours) and severe disease (p = 0.014 and p = 0.007). The results for no disease were mixed: for the first 12 hours there was a poor correlation, but the results for the second 12 hours correlated well. The protein:creatinine ratio had a significant correlation (p = 0.02), using a cutoff of 0.15, returned specificity of 50%, sensitivity of 100%, positive predictive value of 75% and negative predictive value of 100%. CONCLUSION: Total protein values for 12- and 24-hour urine samples correlate well for the diagnosis of preeclampsia. A protein:creatinine ratio of ≤0.15 rules out significant proteinuria. In combination, these 2 tests may allow more rapid diagnosis of preeclampsia.

Original languageEnglish
Pages (from-to)709-714
Number of pages6
JournalJournal of Reproductive Medicine for the Obstetrician and Gynecologist
Volume51
Issue number9
StatePublished - Sep 2006

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Proteinuria
Creatinine
Proteins
Urine
Pre-Eclampsia
Regression Analysis
Sensitivity and Specificity
Pregnancy

Keywords

  • Gestational hypertension
  • Pregnancy complications, cardiovascular
  • Proteinuria

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Reproductive Medicine

Cite this

Alternate evaluations of proteinuria in the gravid hypertensive patient. / Schubert, Frank; Abernathy, Mary P.

In: Journal of Reproductive Medicine for the Obstetrician and Gynecologist, Vol. 51, No. 9, 09.2006, p. 709-714.

Research output: Contribution to journalArticle

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abstract = "OBJECTIVE: To determine if the 12-hour urine total protein value correlates with the 24-hour value and to evaluate the random protein:creatinine ratio as a predictor of significant proteinuria (≥ 300 mg/24 h) for use in diagnosing preeclampsia. STUDY DESIGN: The study population included 15 patients with hypertensive disorders of pregnancy. The patients' urine was collected over 24 hours in 2 12-hour aliquots. The urine volume, total protein and creatinine were measured. The patients' initial voids were collected and evaluated for random urine protein and creatinine and calculation of the protein:creatinine ratio. The protein:creatinine ratio and 12-hour results were compared to the 24-hour results using simple regression analysis. RESULTS: Of the 15 patients, 6 had no proteinuria, 5 had mild proteinuria, and 4 had severe proteinuria (60{\%} with significant proteinuria). The 12-hour protein results correlated with the 24-hour results for patients with mild disease (p = 0.00007, first 12 hours, and p = 0.012, second 12 hours) and severe disease (p = 0.014 and p = 0.007). The results for no disease were mixed: for the first 12 hours there was a poor correlation, but the results for the second 12 hours correlated well. The protein:creatinine ratio had a significant correlation (p = 0.02), using a cutoff of 0.15, returned specificity of 50{\%}, sensitivity of 100{\%}, positive predictive value of 75{\%} and negative predictive value of 100{\%}. CONCLUSION: Total protein values for 12- and 24-hour urine samples correlate well for the diagnosis of preeclampsia. A protein:creatinine ratio of ≤0.15 rules out significant proteinuria. In combination, these 2 tests may allow more rapid diagnosis of preeclampsia.",
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