Albumin to creatinine ratio in a random urine sample: Correlation with severity of preeclampsia

Background: Albumin to creatinine ratio (ACR) in random urine samples correlates well with 24-h protein excretion in potential glomerulopathy as in diabetic renal microangiopathy. Using this ratio as an appropriate screening test for proteinuria or for the disease severity in hypertensive disorders with pregnancy needs still to be verified. Objective: To investigate the role of albumin to creatinine ratio in a random urine sample for assessment of severity of preeclampsia. Patients methods: Two separate groups, fifty women each, were enrolled. All were pregnant at their third trimester with confirmed preeclampsia. Based on their blood pressure levels, Group A, included patients with mild form of preeclampsia, whereas group B included cases with severe form. Albumin to creatinine ratio in random urine samples and the 24-h protein content in urine were assessed. Results: ACR and the 24-h urine protein excretion were significantly correlated, (r =0.583, p 0.001). Cut-off value for ACR for this group of patients was calculated to be 14.65 mg/mmol, above which severity of the disease is highly probable. The sensitivity and specificity were 100% and 58.0%, respectively. The positive predictive value was 70.4% and negative predictive value was 100%. Conclusions: Random urine ACR may be a reliable method for prediction and assessment of severity of preeclampsia. Using the estimated cut-off may add to the predictive value of such a simple quick test.