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  • Title: The protein-to-creatinine ratio for the prediction of significant proteinuria in patients at risk for preeclampsia: a meta-analysis.
    Author: Sanchez-Ramos L, Gillen G, Zamora J, Stenyakina A, Kaunitz AM.
    Journal: Ann Clin Lab Sci; 2013; 43(2):211-20. PubMed ID: 23694798.
    Abstract:
    OBJECTIVE: To investigate the diagnostic accuracy of the protein-to-creatinine ratio from random urine collections to confirm the presence of proteinuria in women being evaluated for preeclampsia. STUDY DESIGN: Eligible studies, published between January 1966 and April 2010, were retrieved through general bibliographic databases. Accuracy of the protein-to-creatinine ratio was estimated compared with a 24- hour urine collection. Pooled estimates of diagnostic measures were calculated. A random-effects bivariate model was employed. RESULTS: Twenty-four trials with 3,186 aggregate participants met inclusion criteria. Pooled sensitivities and specificities were 91.0% (95%CI 87.0 - 93.9) and 86.3% (95% CI 78.4 - 91.7) respectively. Pooled positive likelihood ratio was 6.7 (95% CI 4.1, 10.9) and pooled negative likelihood ratio 0.10 (95%CI 0.07, 0.16). Meta-regression analysis found that test accuracy was not affected by any of the co-variables explored. CONCLUSION: A random urine protein-to-creatinine ratio provides useful evidence to rule out the presence of significant proteinuria in patients at risk for preeclampsia. It appears that a cut-off value of > 0.30 is associated with the best accuracy. CONDENSATION: The protein-to-creatinine ratio from a random urine sample provides useful evidence to rule out the presence of significant proteinuria in patients at risk for preeclampsia.
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