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Albumin to creatinine ratio in 2 random urine samples was an accurate screening test for albuminuria in diabetic pregnancies

Clinical impact ratings GP/FP/Primary care Obstetrics Endocrine Nephrology

Key Words: diabetes mellitus (type 1) • pregnancy • pre-eclampsia • diabetic nephropathies

The first 150 words of the full text of this article appear below.

METHODS
Design: prospective cohort study.

Setting: university hospital in Copenhagen, Denmark.

Patients: 119 pregnant women (mean age 30 y) with type 1 diabetes who were enrolled at <14 weeks’ gestation.

Description of test: median albumin to creatinine ratio in 2 (or 3 if there was disagreement between the first 2) random urine samples taken at 7–22 weeks’ gestation, with no restrictions on time of day, diet, or exercise. Microalbuminuria was defined as 2.5 or 3.5–25 mg/mmol (21 or 30–210 µg/mg creatinine) and macroalbuminuria as >25 mg/mmol (>210 µg/mg creatinine).

Diagnostic standard: median albumin excretion (measured by enzyme linked immunosorbent assay) in two 24 hour urine collections. Microalbuminuria was defined as 30–300 mg/24 h and macroalbuminuria as >300 mg/24 h.

Outcomes: sensitivity, specificity, and likelihood ratios.

MAIN RESULTS
Based on the 24 hour urine collections, microalbuminuria was present in 7 women (5.9%) and macroalbuminuria in 9 women (7.6%). The correlation coefficient between the 24 . . . [Full text of this article]

Chris L Bryson, MD, MS, Lorien Dalrymple, MD, MPH

Health Services Research and Development, Seattle,
Washington, USA