Random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with preeclampsia

Objective: To evaluate the accuracy of random urinary protein-to-creatinine ratio for prediction of significant proteinuria in women with suspected preeclampsia. Methods: A prospective study was conducted in hospitalized pregnant women with a suspicion of preeclampsia. Random mid-stream urine specimens were obtained for protein-to-creatinine ratio determination, and then participants were instructed to collect 24-h urine samples for protein measurement. With the criterion of 24-h proteinuria of at least 300 mg as a significant proteinuria, the sensitivity and specificity of a random urinary protein-to-creatinine ratio of ≥ 0.19 for prediction of significant proteinuria were analyzed and a receiver operating characteristic curve was constructed to determine the optimal cutoff value. Results: Forty-two patients completed the study. Sixty-nine percent of the study population had significant proteinuria. A cutoff of ≥ 0.19 demonstrated a sensitivity of 100% and a specificity of 53.8%. A ratio below 0.22 could rule out a significant proteinuria. The optimal cutoff value is 0.25 which yielded sensitivity, specificity and accuracy of 96.6%, 92.3% and 95.2% respectively. Conclusion: In hospitalized preeclamptic patients, the random urinary protein-to-creatinine ratio at a cutoff of ≥ 0.25 revealed a highly accurate prediction of significant proteinuria and could be a more practical alternative for assessment of proteinuria.