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Master Thesis

Évaluation de la concordance statistique du ratio protéinurie/créatininurie, en comparaison de la protéinurie des 24 heures, chez les patientes pré-éclamptiques

Abstract : AIMS: To assess the correlation between 24-hour urine sample proteinuria (P24), the gold standard in the diagnosis of preeclampsia, and the protein/creatinine ratio (PCR). METHODS: All patient under 20 weeks of amenorrhea, with preeclampsia, was included, from the 1st April to the 31 December 2014 in the Saint Denis hospital (Reunion Island), and from the 1st January to the 31 December 2015 in the Bordeaux hospital (France). They made one P24 and PCR at the same time in the same hospital. We determinate a Bland and Altman plot, and intraclasse correlation coefficient (kappa, k) to compare both of them. A ROC curve was made to determine the diagnostic performance. RESULTS: 178 patients were included, with 302 (P24-PCR) pairs analysed. The Bland and Altman plot revealed an excellent correlation between P24 and PCR, and the k coefficient was 0,90 (confidence interval CI 95%:0.88-0.92). For the diagnosis of preeclampsia, with a cut off of 24-hour urine protein of 0,3 g/mmol, the sensitivity of the PCR was 92,2% (CI 95%: 89-95.3), the positive likelihood ratio was 96,6% (CI95%: 54.5-98.8). For the severe preeclampsia, with a 1,98 g/mmol cut off, the specificity was 96,2% (CI 95%: 87-96.4) and the positive likelihood ratio 94,1% (CI95%: 90-97.3). CONCLUSIONS: PCR has an excellent agreement with the P24, and a good diagnostic performance during the pregnancy. This test is easier to do, with a quick result and cheaper than P24. It allows an optimized care, for the mother and the foetus, in the preeclampsia. It could be proposed in current practice, instead of the P24.
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Master Thesis
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https://dumas.ccsd.cnrs.fr/dumas-01583393
Contributor : Bu Carreire Université de Bordeaux <>
Submitted on : Thursday, September 7, 2017 - 11:57:06 AM
Last modification on : Friday, November 8, 2019 - 5:58:08 PM

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Marine Belhadia. Évaluation de la concordance statistique du ratio protéinurie/créatininurie, en comparaison de la protéinurie des 24 heures, chez les patientes pré-éclamptiques. Médecine humaine et pathologie. 2016. ⟨dumas-01583393⟩

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