Use of Protein: Creatinine ratio measurements on random urine samples for prediction of significant proteinuria, a systematic review, ” Clin. Chem

dent risk factor for cardiovascular and renal disease and as a predictor of end organ damage. The reference test, a 24-h urine protein estimation, is known to be unreliable. A random urine protein:creatinine ratio has been shown to correlate with a 24-h estimation, but it is not clear whether it can be used to reliably predict the presence of significant proteinuria. Methods: We performed a systematic review of the literature on measurement of the protein:creatinine ratio on a random urine compared with the respective 24-h protein excretion. Likelihood ratios were used to deter-mine the ability of a random urine protein:creatinine ratio to predict the presence or absence of proteinuria. Results: Data were extracted from 16 studies investigat-ing proteinuria in several settings; patient groups stud-ied were primarily those with preeclampsia or renal disease. Sensitivities and specificities for the test