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Random Urine Protein-Creatinine Ratio to Predict Proteinuria in New-Onset Mild Hypertension in Late Pregnancy

Ragip A. Al, MD^*, Cem Baykal, MD^*, Ozlem Karacay, MD^*, Pinar O. Geyik, PhD, Serpil Altun, MD and Ismail Dolen, MD^*

From the *Departments of Obstetrics and Gynecology and Biochemistry, SSK Ankara Maternity and Women's Health Hospital, and Department of Biostatistics, Hacettepe University Faculty of Medicine, Ankara, Turkey.

Address reprint requests to: R. Atakan Al, Cigdem Mah. 357. Sok, Segmen sitesi A Blok No 7/25, 06530 Karakusunlar, Ankara, Turkey; e-mail: atakanal{at}superonline.com.

OBJECTIVE: The aim of this study was to evaluate the diagnostic accuracy of random urine protein-creatinine ratio for prediction of significant proteinuria ( 300 mg/24 h) in patients with new-onset mild hypertension in late pregnancy.

METHODS: Medical records of 185 consecutive pregnant patients with new onset of mild hypertension in late pregnancy were reviewed. Random urine samples were taken before 24-hour urine collection. The predictive values of the random urine protein-creatinine ratio for diagnosis of significant proteinuria were estimated by using at least a 300-mg protein level within the collected 24-hour urine as the gold standard.

RESULTS: Thirty-nine patients (21%) had significant proteinuria. There was a significant association between 24-hour protein excretion and the random urine protein-creatinine ratio (r_s = 0.56, P < .01). With a cutoff protein-creatinine ratio greater than 0.19 as a predictor of significant proteinuria, sensitivity and specificity were 85% and 73%, respectively. Positive and negative predictive values of the test were 46% and 95%, respectively.

CONCLUSION: The random urine protein-creatinine ratio was a poor predictor for significant proteinuria in patients with new-onset mild hypertension in late pregnancy.

LEVEL OF EVIDENCE: II-3

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