A prospective comparison of random urine protein-creatinine ratio vs 24-hour urine protein in women with preeclampsia.

OBJECTIVE: To assess the diagnostic accuracy of random urine protein-creatinine ratio for the prediction of significant proteinuria in patients with preeclampsia.

STUDY DESIGN: 155 pregnant patients diagnosed to have hypertension in late pregnancy were instructed to collect urine during a 24-hour period. Protein-creatinine ratio was evaluated in a random urinary specimen. Out of these, 120 patients fulfilled the inclusion criteria. The predictive value of the random urinary protein-creatinine ratio for the diagnosis of significant proteinuria was estimated by using a 300-mg protein level within the collected 24-hour urine as the gold standard.

RESULTS: 104 patients (86.67%) had significant proteinuria. There was significant association between 24-hour protein excretion and the random urine protein-creatinine ratio (r(s)=0.596, P < .01). With a cut-off protein-creatinine ratio greater than 1.14 as a predictor of significant proteinuria, sensitivity and specificity were 72% and 75%, respectively. The positive predictive value was 94.9% and negative predictive value was 29.2%.

CONCLUSION: The random urine protein-creatinine ratio was not a good predictor of significant proteinuria in patients with preeclampsia.