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1. Rev Obstet Gynecol. 2012;5(1):9-15.

Urinary spot albumin:creatinine ratio for documenting proteinuria in women with
preeclampsia.

Huang Q, Gao Y, Yu Y, Wang W, Wang S, Zhong M.

Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical
University Guangzhou, Guangdong Province, China.

Aim: To assess whether a single urinary spot urinary albumin:creatinine ratio
(ACR) can be used to estimate 24-hour urinary protein excretion in women with
preeclampsia. Methods: ACR and 24-hour urinary protein excretion were measured in
50 consecutive patients with preeclampsia. ACR was determined in a spot midstream
urine sample and the amount of protein excretion was quantified in a 24-hour
urine collection performed the following day. The correlation between the spot
ACR and 24-hour urine protein excretion was assessed, and the diagnostic value of
ACR was expressed in terms of specificity and sensitivity. Receiver operating
characteristic curve analysis was used to determine the best cutoff values of the
spot ACR for mild preeclampsia (proteinuria ≥ 0.3 g/24 h) and severe preeclampsia
(defined in China as proteinuria ≥ 2 g/24 h). Results: A strong correlation was
evident between the spot ACR and 24-hour urinary protein excretion (r = .938; P <
.001). The optimal spot ACR cutoff point was 22.8 mg/mmol for 0.3 g/24 h of
protein excretion (mild preeclampsia) with a sensitivity and specificity of 82.4%
and 99.4%, respectively, and 155.6 mg/mmol for 2 g/24 h of protein excretion
(severe preeclampsia) with a sensitivity and specificity of 90.6% and 99.6%,
respectively. Conclusions: Compared with 24-hour urinary protein excretion, the
spot urinary ACR may be a simple, convenient, and accurate indicator of
significant proteinuria in women with preeclampsia.

PMCID: PMC3349919
PMID: 22582122 [PubMed - in process]