Increases in urinary creatinine and blood pressure during early pregnancy in pre-eclampsia

Abstract

Background: It is important to predict the development of pre-eclampsia (PE) during early pregnancy to prevent its occurrence later on. In this study, we studied urinary biochemical parameters and blood pressure (BP) during and after pregnancy to find useful parameters for predicting PE. Methods: A case-control study was performed in 25 PE patients and 172 normotensive pregnant women. Twelve biochemical parameters were measured in spot urine, and the systolic and diastolic BPs were measured using an automated device during pregnancy and six to eight weeks after birth. Results: A multiple logistic regression analysis showed that the combinations of urinary creatinine (Cr) and systolic BP (SBP) in the first trimester of pregnancy (8.9 + 2.6 weeks), and of urinary inorganic phosphorus (IP)/Cr and SBP in the second trimester of pregnancy (19.0 + 1.6 weeks) were useful for predicting PE. The area under the curve in the receiver operator characteristic curve of the combination of urinary Cr and SBP in the first trimester was 0.85 (95% confidence interval [CI] 0.74-0.96), and that of the combination of urinary IP/Cr and SBP in the second trimester was 0.91 (95% CI: 0.86-0.97). When used 249 mg/dL in urinary Cr and 128 mmHg in SBP as their cut-off points, the combination in the first trimester increased the accuracy (sensitivity 75% and specificity 95%) in predicting PE, as compared with that of urinary Cr (29%, 99%) or SBP (50%, 98%). Conclusions: Combination of urinary Cr and SBP in early pregnancy and that of urinary IP/Cr and SBP in mid-pregnancy are useful for the prediction of PE.

First Trimester Urine and Serum Metabolomics for Prediction of Preeclampsia and Gestational Hypertension: A Prospective Screening Study

“…However, many of the metabolites were not the same as those highlighted here, including the hippurate to creatinine ratio, which might be attributed to the difference in gestational age between the studies resulting in changing metabolic profiles [ 24 ]. Non-metabolomics methods have been used to predict preeclampsia from urine samples, focusing on urinary albumin to creatinine ratios as a measure of kidney function [ 25 ], and creatinine levels in urine [ 26 ]. Increased urinary creatinine was found to be predictive of preeclampsia in a study as early as 8–10 weeks gestation [ 26 ].…”

“…Non-metabolomics methods have been used to predict preeclampsia from urine samples, focusing on urinary albumin to creatinine ratios as a measure of kidney function [ 25 ], and creatinine levels in urine [ 26 ]. Increased urinary creatinine was found to be predictive of preeclampsia in a study as early as 8–10 weeks gestation [ 26 ]. Our corresponding findings of increased creatinine in urine may be an effect of the increased BMI and MAP of the women who developed preeclampsia and gestational hypertension [ 26 ], or possibly a marker of early renal involvement.…”

“…Increased urinary creatinine was found to be predictive of preeclampsia in a study as early as 8–10 weeks gestation [ 26 ]. Our corresponding findings of increased creatinine in urine may be an effect of the increased BMI and MAP of the women who developed preeclampsia and gestational hypertension [ 26 ], or possibly a marker of early renal involvement. Studies have reported increased glomerular filtration rates in pre-hypertensive subjects [ 27 ].…”

Hepatic, Renal and Inflammatory Biomarkers are Positively Associated with Blood Pressure Changes in Healthy Pregnant Women

“… 14 , 15 It has also been reported that renal function is highly correlated with SBP and DBP in women who develop HDP and that the combination of urinary creatinine (Cr) and SBP in early pregnancy can be considered a predictor of PE. 16 , 17 …”