Utilization of urine protein/creatinine ratio in pregnancy for diagnosis of preeclampsia


  • Nagajan Bhadarka Department of Obstetrics and Gynecology, Gujarat Adani Institute of Medical Science, Bhuj, Kutch, Gujarat, India
  • Krutika Poddar Pacific Dental College and Hospital, Udaipur, Rajasthan, India
  • Satyam Joshi Pacific Dental College and Hospital, Udaipur, Rajasthan, India




Createnine, Preeclampsia, Protein, Urine


Background: The aim of the present study was to evaluate the ability of the random urine P/C ratio to predict significant proteinuria, as well as to introduce a diagnostic test for preeclampsia that would avoid the inconvenience and time consumption of 24-hour urine protein collection.

Methods: A total of 100 women who were pregnant were included in the study. For urine test, the urine was collected for 24 hours. The women patients provided the mid stream urine sample prior to the collection period. Biuret colorimetric assay was used to determine the total protein in the urine and the creatinine concentration was measured with the help of modified Jaff test.

Results: The mean urinary protein excretion in 24 hour urine collection was found to be 2.05±0.74 g/dl and the median serum creatinine concentration was found to be 0.82 mg/dl.  The mean p/c ratio was found to be 1.94±0.83. The correlation coefficient for the p/c ratio against the 24 hour urine protein excretion was found to be 0.88.

Conclusions: This test can also be used as a reasonable alternative to 24-hour urine protein excretion, especially in emergency situations, and, it could also complement the urinary dipstick test in preeclamptic pregnancy.



Lim KH, Zhou Y, Janatpour M, McMaster M, Bass K, Chun SH, Fisher SJ. Human cytotrophoblast differentiation/invasion is abnormal in pre-eclampsia. Am J Pathol. 1997;151:1809.

Snydal S. Major changes in diagnosis and management of preeclampsia. J Midwifery Women’s Health. 2014;59:596-605.

Waller K, Ward KM, Mahan JD, Wismatt D. Current concepts in proteinuria. Clinical Chem. 1989;35:755-65.

Khowaja AR, Mitton C, Bryan S, Magee LA, Bhutta ZA, von Dadelszen P. Economic evaluation of Community Level Interventions for Pre-eclampsia (CLIP) in South Asian and African countries: a study protocol. Implementation Sci. 2015;10:76.

Sibai B, Dekker G, Kupferminc M. Pre-eclampsia. Lancet. 2005;365:785-99.

Gruenwald P. Growth of the human fetus: II. Abnormal growth in twins and infants of mothers with diabetes, hypertension, or isoimmunization. Am J Obstet Gynecol. 1966;94:1120-32.

Park JH, Chung D, Cho HY, Kim YH, Son GH, Park YW et al. Random urine protein/creatinine ratio readily predicts proteinuria in preeclampsia. Obstet Gynecol Sci. 2013;56:8-14.

Shreya G, Pranathi L, Kavitha V. Comparison of spot urine protein-creatinine ratio with 24-hour urine protein excretion in women with preeclampsia. Int J Intg Med Sci. 2015;2:55-9.

Hladunewich M, Karumanchi SA, Lafayette R. Pathophysiology of the clinical manifestations of preeclampsia. Clin J Am Soc Nephrol. 2007;2:543-9.

Moser M. Working group report on high blood pressure in pregnancy. J Clin Hypertension. 2001;3:75-88.

Schaub S, Rush D, Wilkins J, Gibson IW, Weiler T, Sangster K et al. Proteomic-based detection of urine proteins associated with acute renal allograft rejection. J Am Soc Nephrol. 2004;15:219-27.

Rodriguez-Thompson D, Lieberman ES. Use of a random urinary protein-to-creatinine ratio for the diagnosis of significant proteinuria during pregnancy. Am J Obstet Gynecol. 2001;185:808-11.

Shahbazian N, Hosseini AF. A comparison of spot urine protein-creatinine ratio with 24-hour urine protein excretion in women with preeclampsia. Iran J Kidney Dis. 2008 Jul;2(3):127-31.

Côté AM, Brown MA, Lam E, von Dadelszen P, Firoz T, Liston RM. Diagnostic accuracy of urinary spot protein: creatinine ratio for proteinuria in hypertensive pregnant women: systematic review. BMJ. 2008;336:1003-6.






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