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Proteinuria or not proteinuria, that is the questionFrom: Paul Prior MD (pprior@clover.net)Tue Jul 31 23:22:29 2001
On the topic of proteinuria, which has been such a hot topic in the last few days, I have this question on which I would like to solicit comments: Do you routinely dip urine (for protein) of all gravidas during each prenatal visit? If so, do you routinely find +1 or greater values? I have not been impressed with the reliability whatsoever of these urine dipsticks. I see so many +1 and even +2 values, that like the boy that cried wolf, it gets easy to ignore them. I've tried different brands, we make sure to follow the timing instructions, but still very frequent false positives. Conversely, I've seen several patients in the last 2 years who dipped negative on office exam, had HTN and were sent for 24 hour urine and indeed had 300+ mg protein. In fact one woman who had a negative dip had ~1.5g/24hr. Thus, in short, the value of these tests seem suspect. Given that Sabai's data have shown that the degree of proteinuria is not prognostic of outcomes, I wonder why I continue to do them. Comments?
-- Paul Prior MD They that can give up essential liberty to obtain a little Coshocton, OH temporary safety deserve neither liberty nor safety. Solo Practice - Benjamin Franklin, 1759. OB/GYN, FACOG
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