The Accuracy of Random Urine Albumin–to–Creatinine Ratio Diagnosing Pre-Eclampsia Compared with Random Microalbuminuria

Abstract

Pre-eclampsia (PEC) is a multisystem complication diagnosed by hypertension and proteinuria or multi-organ problem without signs of proteinuria, which occurs after 20 weeks of gestation. 24-hour Urine Protein to Creatinine Ratio (24-hour UPCR) is a valid test diagnosing PEC; however, collecting urine for 24 hours has several difficulties in practice. Measuring random urine albumin to creatinine ratio (random UACR) in a random urine sample may be an appropriate alternative. It aimed to investigate the diagnostic accuracy of random UACR diagnosing PEC compared with Random microalbuminuria. In a cohort study, suspected pregnant women referring to Hazrat Zeynab hospital during June and September 2017 were followed for PEC development. 24-hour urine samples were taken from the subjects to measure the 24-hour Urine Protein; in addition, random urine samples were taken to measure the random UACR for each. Receiver operator characteristic curve was applied and area under roc curve (AUC), sensitivity, specificity, and positive predictive value (PPV) and negative predictive value (NPV) with 95% Confidence Interval ;( 95% C.I) were estimated using SPSS v.22 at significance level<0.05. From 69 subjects, 33% (23/67) developed PEC and the remaining 67% (46/67) were non-PEC control group. Random UACR greater than 40 mg/g could diagnose PEC with AUC, sensitivity, specificity, PPV, and NPV equal 0.81(0.69-0.93), 0.70 (0.47-0.87), 0.70, and 0.85, respectively. Random microalbuminuria greater than 53.5 mg/lit could diagnose PEC with AUC, sensitivity, specificity, PPV, and NPV equal 0.78(0.66-0.91), 0.70 (0.47-0.87), 0.85(0.71-0.94), 0.70, and 0.85, respectively. Random UACR is accurate enough diagnosing PEC. It is highly recommended to use random UACR as a quicker and cheaper test diagnosing PEC especially in emergencies.