Diagnostic Accuracy of Spot Urine Protein-Creatinine Ratio (UPCR) in Quantification of Proteinuria in Women with Pre-eclampsia

Abstract

Introduction: Pre-eclampsia is a pregnancy-related disorder marked by hypertension and proteinuria after 20 weeks of gestation. Accurate detection of proteinuria is essential, with 24-hour urine collection being the gold standard, though it is time-consuming. The spot urine protein-to-creatinine (P/C) ratio offers a faster alternative.The main aim of this study is to evaluate the diagnostic accuracy of the spot urine P/C ratio compared to 24-hours urinary protein in preeclampsia patients.

Methods: This prospective study was conducted over one year at Pokhara Academy of Health Sciences with 46 pre-eclamptic patients. Spot P/C ratios were compared with 24-hour urinary protein using correlation analysis, sensitivity, specificity, and ROC curve.

Results: The mean 24-hour urinary protein was 695.80 mg/day and mean P/C ratio was 1.63 ± 1.72. A strong correlation was observed (r = 0.767, p < 0.01). At a cutoff of 0.32, the P/C ratio showed 85.4% sensitivity, 80% specificity, 97.2% PPV, and 84.79% accuracy.

Conclusion: The spot urine P/C ratio is a reliable, quick, and accurate method for diagnosing proteinuria in preeclampsia and can be used as an effective alternative to 24-hour urine collection.