Urine Protein to Creatinine Ratio for the Assessment of Bevacizumab-Associated Proteinuria in Patients with Gynecologic Cancers: A Diagnostic and Quality Improvement Study

Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick (U...

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Bibliographic Details
Published in:Diagnostics (Basel) 2024-08, Vol.14 (17), p.1852
Main Authors: Huang, Kuan-Ju, Chang, Wen-Chun, Chen, Chi-Hau, Lin, Wei-Chen, Pan, William Wei-Lin, Hsieh, Hao-I, Hsieh, Yu-Hsiung, Wei, Lin-Hung, Sheu, Bor-Ching
Format: Article
Language:English
Subjects:
albuminuria
angiogenesis inhibitors
antineoplastic agents
bevacizumab
Cancer therapies
Chemotherapy
Cost analysis
Creatinine
Gynecological cancer
Injuries
Kidney diseases
Patients
Proteins
proteinuria
Urine
urine protein to creatinine ratio
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Summary:Proteinuria is a common adverse event arising from treatment with bevacizumab, requiring diagnostic testing via 24-h urine collection. However, this method is cumbersome. We assessed urine screenings in gynecologic cancer patients from February 2021 to May 2022. Along with a simple urine dipstick (UD), the urine microalbumin, total protein, and creatinine were measured and calculated as the urine albumin to creatinine ratio (UACR) and the urine protein to creatinine ratio (UPCR), which were further adjusted through the Modification of Diet in Renal Disease and Chronic Kidney Disease Epidemiology Collaboration equations to be estimated and correlated with 24-h urine total protein content. The incremental cost-effectiveness ratio was used for cost analysis. There were 129 urine samples from 36 patients. The sensitivity and specificity for the UACR were 0.56 and 0.97, and for the UPCR, 0.71 and 0.88, respectively. The 24-h TP correlated strongly with the UACR (r = 0.75; < 0.001) and UPCR (r = 0.79; < 0.001) and fair for the simple UD (r = 0.35; < 0.001). The UPCR saves one unnecessary 24-h urine test for less than a dollar compared to a simple UD. The results indicate that using the UPCR could enhance diagnostic accuracy, lower costs, and reduce unnecessary 24-h urine sampling.
ISSN:2075-4418
2075-4418
DOI:10.3390/diagnostics14171852