Evaluación de las características operativas de la relación proteína / creatinina en orina ocasional para la detección de proteinuria significativa en gestantes con sospecha de preeclampsia

Abstract

Objective: To analyse the sensitivity and specificity of the protein/creatinine ratio in the urine as a method for detecting proteinuria in women with suspected preeclampsia, considering 24-hour proteinuria as the gold standard. Materials and methods: Cross-sectional study that included women with more than 20 weeks of gestation, admitted to Clinica Universitaria Bolivariana in Medellin because of suspected preeclampsia. Pregnant women with urinary infection at the time of the study, patients with a history of chronic diseases that could cause proteinuria, and women who did not complete the sample collection were excluded. Urine protein/creatinine ratio as well as proteinuria were measured in all the patients included in the study. The correlation between the two tests and the cutoff point for the protein/creatinine ratio with the best performance for the detection of significant proteinuria were evaluated. Results: Overall, 200 urine samples were included and significant proteinuria was found in 27 % of the total number of samples. The protein/creatinine ratio in occasional urine was found to have a high correlation with 24-hour proteinuria(r = 0.775, p < 0.01). The cut-off point with the best performance for detecting significant proteinuria was found to be 0.30 mg /mg, with an 83 % sensitivity and a 98 % specificity, with a positive LR of 60 and a negative LR of 0.17. Conclusion: The protein/creatinine ratio in occasional urine may be used as a fast alternative method for determining the presence of proteinuria in patients with suspected preeclampsia.