Session Type: ACR Poster Session C
Session Time: 9:00AM-11:00AM
review literature on the utility of spot urinary protein-creatinine ratio (PCR)
as a screening test for proteinuria and its ability to accurately measure
proteinuria compared with 24 hour urine collection (24H-P) in patients with
Systemic Lupus Erythematosus (SLE).
Methods: Literature search
(1900 – 2015) for articles comparing PCR and 24H-P in SLE patients in the
databases Medline, Web of Science and Embase. Included studies and their
results were critically appraised and analyzed.
Results: 13 studies (1001
patients; 84.01% women) were included. 10 studies reported on Pearson
correlation (range: 0.67-0.94); 3 studies reported on Spearman correlation
(range: 0.78-1). The meta-analysis of studies with Pearson correlation showed
a high overall correlation of 0.80 between 24H-P and PCR (Figure 1) however with
high heterogeneity (I2=97.2%). Correlation analysis is not
sufficient to evaluate the utility of a new test against the gold standard test
and analysis on agreement is required. Seven studies reported on agreement: 3
studies analyzed Concordance Correlation Coefficient (0.48-0.94); 3 Intraclass
Correlation Coefficient (0.66-0.95) and 1 kappa (0.58). These results confirmed
that the agreement between 24H-P and PCR was inappropriate. Three studies included
Bland-Altman plot and the results also demonstrated poor agreement between both
Conclusion: The PCR has a utility
as a screening test for proteinuria in SLE patients. The studies’ results of 24H-P
and PCR showed poor agreement between both tests signifying that PCR should not
substitute the gold standard test (24H-P) to accurately measure proteinuria.
plot of correlations for the 8 studies included in the meta-analysis for the
overall correlation of 24H-P and PCR
To cite this abstract in AMA style:Medina-Rosas J, Yap K, Anderson M, Su J, Touma Z. Diagnostic and Screening Accuracy of Spot Urinary Protein-Creatinine Ratio Compared to Protein Content in a 24 Hour-Urine Collection in Systemic Lupus Erythematosus: Systematic Review and Meta-Analysis [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/diagnostic-and-screening-accuracy-of-spot-urinary-protein-creatinine-ratio-compared-to-protein-content-in-a-24-hour-urine-collection-in-systemic-lupus-erythematosus-systematic-review-and-meta-analysi/. Accessed June 24, 2019.
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