D. Rochiguez-thompson et Es. Lieberman, Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy, AM J OBST G, 185(4), 2001, pp. 808-811
OBJECTIVE: The purpose of this study was to evaluate whether a random urina
ry protein-to-creatinine ratio is a clinically useful predictor of signific
ant proteinuria (300 mg/24 hour),
STUDY DESIGN: The medical records of 138 women who completed both a random
urinary protein-to-creatinine ratio and a 24-hour urine collection for the
evaluation of preeclampsia were reviewed. Urine samples for the random prot
ein-to-creatinine ratio were collected before the 24-hour urine collection.
With the use of a protein level of at least 300 mg in the 24-hour urine sa
mple as the gold standard, the sensitivity and specificity of the random pr
otein-to-creatinine ratio for the diagnosis of significant proteinuria were
determined with a range of cutoffs.
RESULTS: Fifty percent of the study population had significant proteinuria.
The data suggest that a cutoff below 0.14 ruled out significant proteinuri
a. The best cutoff of greater than or equal to 0.19 yields a sensitivity of
90% and a specificity of 70%. All of the false-negative test results had 2
4-hour urine protein levels below 400 mg; 13 of the 21 false-positive resul
ts had levels that ranged from 250 to 300 mg.
CONCLUSION: The random urinary protein-to-creatinine ratio is strongly asso
ciated with the 24-hour total protein excretion. A level below 0.14 can rul
e out significant proteinuria. A best cutoff of greater than or equal to 0.
19 is a good predictor of significant proteinuria. With further study, the
random urinary protein-to-creatinine ratio could replace the 24-hour urine
collection as a simpler, faster, more useful method for the diagnosis of si
gnificant proteinuria.