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Problems in methods for the detection of significant proteinuria in pregnancy

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Title: Problems in methods for the detection of significant proteinuria in pregnancy
Authors: Yamada, Takahiro Browse this author →KAKEN DB
Kojima, Takashi Browse this author
Akaishi, Rina Browse this author
Ishikawa, Satoshi Browse this author
Takeda, Masamitsu Browse this author
Kawaguchi, Satoshi Browse this author
Nishida, Ryutaro Browse this author
Morikawa, Mamoru Browse this author →KAKEN DB
Yamada, Takashi Browse this author →KAKEN DB
Minakami, Hisanori Browse this author →KAKEN DB
Keywords: proteinuria
creatinine in the urine
protein to creatinine ratio
Issue Date: Jan-2014
Publisher: Blackwell Publishing
Journal Title: Journal of Obstetrics and Gynaecology Research
Volume: 40
Issue: 1
Start Page: 161
End Page: 166
Publisher DOI: 10.1111/jog.12148
PMID: 24102664
Abstract: Aim: The aim of this study was to underscore problems associated with the dipstick test and determination of protein concentration alone in spot-urine (P-test) compared with spot-urine protein-to-creatinine ratio (P/Crtest) and to determine whether urine collection for 24-h test was complete. Material and Methods: Dipstick and P/Cr tests were performed simultaneously in 357 random spot-urine specimens from 145 pregnant women, including 35 with pre-eclampsia. Positive results were defined as 1+ on dipstick test, protein concentration 30 mg/dL on P-test, and P/Cr ratio 0.27 (mg/mg) on P/Cr test. Sixty-four 24-h urine tests (quantification of protein in urine collected during 24 h) were performed in 27 of the 145 women. We assumed that P/Cr ratio 0.27 predicted significant proteinuria (urinary protein 0.3 g/day). The 24-h urine collection was considered incomplete when urinary creatinine excretion was <11.0 mg/kg/day or >25.0 mg/kg/day. Results: Forty-four percent (69/156) of specimens with a positive test result on dipstick test contained protein < 30 mg/dL. Dipstick test was positive for 25.7% (69/269) of specimens with protein < 30 mg/dL and for 28.8% (79/274) of specimens with P/Cr ratio < 0.27. P-test results were positive for 7.3% (20/274) and negative for 18.1% (15/83) of specimens with P/Cr ratio < 0.27 and 0.27, respectively. Incomplete 24-h urine collection occurred in 15.6% (10/64) of 24-h urine tests. Daily urinary creatinine excretion was 702–1397 mg, while creatinine concentration varied from 16 mg/dL to 475 mg/dL in spot-urine specimens. Conclusion: Dipstick test and P-test were likely to over- and underestimate risks of significant proteinuria, respectively. The 24-h urine collection was often incomplete.
Rights: The definitive version is available at Wiley Online Library ,
Type: article (author version)
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 水上 尚典

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