Correlation of 2 hour, 4 hour, 8 hour and 12 hour urine protein with 24 hour urinary protein in preeclampsia.
AbstractObjective: To find shortest and reliable time period of urine collection for determination of proteinuria.Materials and methods: It is a prospective study carried out on 125 pregnant women with preeclampsia after 20 weeks of gestation having urine albumin >1 using dipstick test. Urine was collected in five different time intervals in colors labeled containers with the assistance of nursing staff; the total collection time was 24 hours. Total urine protein of two-hour, four-hour, eight-hour, 12-hour and 24-hour urine was measured and compared with 24-hour collection. Data was analyzed using the Pearson correlation coefficient.Results: There was significant correlation (p value < 0.01) in two, four, eight and 12-hour urine protein with 24-urine protein, with correlation coefficient of 0.97, 0.97, 0.96 and 0.97, respectively. When a cut off value of 25 mg, 50 mg. 100 mg, and 150 mg for urine protein were used for 2-hour, 4-hours, 8-hour and 12-hour urine collection, a sensitivity of 92.45%, 95.28%, 91.51%, and 96.23% and a specificity of 68.42%, 94.74%, 84.21% and 84.21% were obtained, respectively.Conclusion: Two-hour urine proteins can be used for assessment of proteinuria in preeclampsia instead of gold standard 24-hour urine collection for early diagnosis and better patient compliance.
Norwitz ER, Robinson JN, Repke JT. Prevention of preeclampsia: Is it possible? Clin Obstet Gynecol 1999; 42:436-54.
Cunningham FG, Hauth JC, Leveno KJ, Gilstrap L, Bloom SL, Wenstrom KD. In Hypertensive disorders in pregnancy. Williams Obstetrics. 22ⁿd ed. McGraw Hill: New York: 2005: 762-5.
Von Dadelszen P, Magee LA, Taylor EL, Muir JC, Stewart SD, Sherman P et al. Maternal hypertension and neonatal outcome among small for gestational age infants. Obstet Gynecol 2005; 106: 335-9.
Kuo VS, Koumantakis G, Gallery E. Proteinuria and its assessment in normal and hypertensive pregnancy. Am J Obstet Gynecol 1992; 167: 723-8.
Durnwald C, Mercer B. A prospective comparison of total protein/creatinine ratio versus 24 hour urine protein in women with suspected preeclampsia. Am J Obstet Gynecol 2003; 189: 848-52.
Airoldi J, Weinstein L. Clinical significance of proteinuria in pregnancy. Obstetrical and Gynecological Survey 2007; 62: 117-24.
Ginsberg JM, Chang B, Matarese R, Garella S. Use of single voided urine samples to estimate quantitative proteinuria. N Eng J Med 1983; 309: 1543-6.
Rinehart BK, Terrone DA, Larmon JE, Perry KG Jr, Martin RW, Martin JN Jr. A 12 hour urine collection accurately assesses proteinuria in hospitalized hypertensive gravida. J Perinatol 1999; 19: 556-8.
Tara F, Mansouri A, Ravanabakhsh F, Tahersima Z. Using 2-hour/ 6 hour Urine protein measurement as substitute diagnostic method for evaluation of preeclampsia. Int J Obstet Gynecol 2008; 10; 1-7.
Kieler H, Zettergren T, Svensson H, Dickman PW, Larrson A. Assessing urinary albumin excretion in pre-eclamptic women. Which sample to use? Br J Obstet Gynecol 2003; 110: 12-7.
Adelberg AM, Miller J, Doerzbacher M, Lambers DS. Correlation of quantitative protein measurements in 8-, 12-, and 24-hour urine samples for diagnosis of preeclampsia. Am J Obstet Gynecol 2001; 185: 804-7.
Somnathan N, Farrel T, Galimberti A. A comparison between 24-hour and 2-hour urine collection for the determination of proteinuria. J Obstet Gynecol 2003;23: 373-80.
Rabiee S. Comparison of predictive value of 8, 12 and 24 hour proteinuria in preeclampsia. Pak J Med Sci 2007; 23: 182-4.
Wongkitisophon K, Phupong V, Yamasmit W, Pansin P, Tannirandorn Y, Charoenvidhya D. Correlation of 4- and 24- hour urine protein in women with initially diagnosed hypertensive disorder in pregnancy. J Med Assoc Thai 2003; 86: 529-34.
Evans W, Lensmeyer JP, Kirby RS, Malnory ME, Broekhuizen FF. Two hour urine collection for evaluating renal function correlates with 24- hour urine collection in pregnant patients. J Matern Fetal Med 2000; 9: 233-7.