Comparison of the Spot Urine Protein Creatinine Ratio with 24 Hours Urine Protein Excretion in Women with Pre-Eclampsia

Abstract

Objective:To assess the diagnostic accuracy of random urine protein / creatinine ratio for the prediction of significant proteinuria in women with pre-eclampsia.

Methodology:The descriptive study was conducted in the department of Obstetrics/Gynecology at Liaquat University Hospital Jamshoro/Hyderabad from Oct 2015 to April 2015. Patient more than 20 weeks of gestation with hypertension with all age group and parity were included. All women were asked to provide a 24 Hours urine collection. The subjectswere advised to pass urine at 8:00 AM and collect all urine subsequently till 8:00 AM next morning Random sample for P/C ratio collected the next morning simultaneously after 24 Hours urine collection is over. Urinary protein quantification was done by biuret method and urinary creatinine by modified Jaffe's method. The result provided by Lab were calculated to obtain ratios by principal investigator using mathematical calculation.Relevant information was recorded on predisposed Proforma.Data were entered and analyzed in statistical program SPSS version 26.

Results:Total 60 women were studiedtheir mean age was 28.32±4.65 years. 26.6% women had gestational hypertensive, 43.3% were mild pre-eclamptic and 30.0% were severe pre-eclamptic. It was noted that the correlation coefficient at lesser degree of proteinuria (i.e less than 300mg) was less (0.69), as compared to other two groups, but statistically significant at (p-0.044). A fair correlation coefficient of r= 0.802 was observed between the 24 hours urine protein and spot urine protein/Creatinine ratio among 60 women which was statistically significant at p value <0.001. It was noticed that the correlation coefficient at lesser degree of proteinuria (i.eless than 300mg) was less (0.802), as compared to other two groups, but statistically significant at (p-0.04).

Conclusion:Significant correlation coefficient was observed between the 24 hours urine protein and spot urine protein/Creatinine ratio. It was observed to be useful in an outpatient setting to predict clinically significant proteinuria and to monitor renal functions in such women with lesser degrees of proteinuria thus avoiding unnecessary Hospital admissions. Method for quantitation of proteinuria, when properly interrupted, can provide valuable information that for clinical purposes is a satisfactory substitute for testing 24hour urine protein for the diagnosis of preeclampsia.