Renal markers in normal and hypertensive disorders of pregnancy in Indian women: a pilot study

Padma, Y; Aparna, Varikuti; Kalpana, B; Ritika, .; Sudhakar, P.

doi:10.5455/2320-1770.ijrcog20131205

Cited by 17 publications

(7 citation statements)

References 37 publications

(48 reference statements)

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“…Renal function is often closely monitored in pre-eclamptic patients as it is a major concern [40,41] with the primary goal of timely delivery before irreversible kidney injury develops. Serum creatinine, serum CysC, and uric acid concentration are parameters that have been used previously to monitor renal function in hypertensive disorders of pregnancy [42–45].…”

Section: Discussionmentioning

confidence: 99%

Cystatin C as a novel predictor of preterm labor in severe preeclampsia

Wattanavaekin

Kitporntheranunt

Kreepala

2018

Kidney Res Clin Pract.

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BackgroundThe most common cause of acute kidney injury (AKI) in pregnancy is preeclampsia. Serum cystatin C (CysC) is a potential biomarker of early kidney damage as its levels are not disturbed by volume status changes in pregnancy, and serum CysC levels could serve as a replacement for conventionally used creatinine. In this study, we investigated the serum levels of CysC in severe preeclampsia cases and the associations between CysC levels and poor obstetric outcomes.MethodsOur cohort included severe preeclampsia patients with a normal serum creatinine level. Creatinine was measured to calculate estimated glomerular filtration rate (eGFR) based on the Cockcroft and Gault, Modification of Diet in Renal Disease Study (MDRD), and Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equations, while CysC was measured to calculated eGFR based on a CysC-based equation. We then evaluated the correlations between serum CysC level, eGFR, and obstetric outcomes.ResultsTwenty-six patients were evaluated of which 38.5% delivered preterm and 30.8% had low-birth weight babies. Unlike creatinine-based eGFR and CysC-based eGFR, serum CysC demonstrate significant negative correlation with gestational age. Receiver operating characteristic curve analysis indicated that serum CysC is a potential biomarker of preterm delivery with a cut-off serum level of 1.48 mg/L with 80% sensitivity and 75% specificity.ConclusionGFR estimation using CysC is likely to be inaccurate in pregnancy. However, we found a significant correlation between preterm delivery and serum CysC level. Our results suggest that serum CysC level has the potential to predict preterm delivery in severe preeclampsia patients.

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Section: Discussionmentioning

confidence: 99%

Cystatin C as a novel predictor of preterm labor in severe preeclampsia

Wattanavaekin

Kitporntheranunt

Kreepala

2018

Kidney Res Clin Pract.

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“…Plasma creatinine (Cr), uric acid (UA), and estimated glomerular filtration rate (eGFR) are widely used as indicators for renal dysfunction (9,10). Previous case-control studies have found that serum GGT, ALP, LDH, and UA levels are increased in women diagnosed with HDP (11)(12)(13)(14)(15)(16)(17). Recently, several studies have reported that lower AST/ALT was associated with insulin resistance, metabolic syndrome and cardiovascular disease (18)(19)(20).…”

Section: Introductionmentioning

confidence: 99%

Increased Uric Acid, Gamma-Glutamyl Transpeptidase and Alkaline Phosphatase in Early-Pregnancy Associated With the Development of Gestational Hypertension and Preeclampsia

Chen

Ou²,

Lin³

et al. 2021

Front. Cardiovasc. Med.

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Background: Previous studies have reported that biomarkers of liver injury and renal dysfunction were associated with hypertensive disorders of pregnancy (HDP). However, the associations of these biomarkers in early pregnancy with the risk of HDP and longitudinal blood pressure pattern during pregnancy were rarely investigated in prospective cohort studies.Methods: A total of 1,041 pregnant women were enrolled in this prospective cohort study. BP was assessed in four stages throughout pregnancy. The following biomarkers were measured at early pregnancy before 18 weeks gestation: lactate dehydrogenase (LDH), aspartate aminotransferase to alanine aminotransferase ratio (AST/ALT), gamma-glutamyl transpeptidase (GGT), alkaline phosphatase (ALP), uric acid (UA), and estimated glomerular filtration rate (eGFR). Linear mixed-effects and logistic regression models were used to examine the associations of these biomarkers with longitudinal BP pattern during pregnancy and HDP incidence, respectively.Results: In unadjusted models, higher serum UA, GGT, ALP, and LDH levels, as well as lower eGFR and AST/ALT, were associated with higher BP levels during pregnancy and an increased risk of HDP. After adjustment for maternal age, pre-pregnancy BMI and other potential confounders, UA, GGT, ALP, and LDH remained positively associated with both BP and HDP. However, eGFR and AST/ALT were not associated with HDP after adjusting for potential confounders. When including all 6 biomarkers simultaneously in multivariable analyses, increased UA, GGT, and ALP significantly associated with gestational hypertension and preeclampsia.Conclusion: This study suggests that increased UA, GGT, and ALP in early-pregnancy are independent risk factors of gestational hypertension and preeclampsia.

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“…To date, Diclegis has not been studied specifically in patients with hyperemesis gravidarum. However, a study by Maltepe and Koren [41] suggests that preconception treatment with Diclegis can decrease the rates of hyperemesis gravidarum.…”

Section: Diclegismentioning

confidence: 99%

Hyperemesis Gravidarum: A Review of Recent Literature

et al. 2017

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Background: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown. Although cases of mortality are rare, hyperemesis gravidarum has been associated with both maternal and fetal morbidity. The current mainstay of treatment relies heavily on supportive measures until improvement of symptoms as part of the natural course of hyperemesis gravidarum, which occurs with progression of gestational age. However, studies have reported that severe, refractory disease manifestations have led to serious adverse outcomes and to termination of pregnancies. Summary: Despite extensive research in the field, the pathogenesis of hyperemesis gravidarum remains unknown. Recent literature points to a genetic predisposition in addition to previously studied factors such as infectious, psychiatric, and hormonal contributions. Maternal morbidity is common and includes psychological effects, financial burden, clinical complications from nutritional deficiencies, gastrointestinal trauma, and in rare cases, neurological damage. The effect of hyperemesis gravidarum on neonatal health is still debated in literature with conflicting results regarding outcomes of birth weight and prematurity. Available therapy options remain largely unchanged in the past several decades and focus on parenteral antiemetic medications, electrolyte repletion, and nutritional support. Most studies of therapeutic options do not consist of randomized control studies and cross-study analysis is difficult due to considerable variation of diagnostic criteria. Key Messages: Hyperemesis gravidarum carries a significant burden on maternal health and US health care. Most published research on pathogenesis is observational and suggests multifactorial associations with hyperemesis gravidarum. Precise, strictly defined criteria for clinical diagnosis are likely to benefit meta-analyses of further research studies regarding pathogenesis as well as therapeutic options.

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Renal markers in normal and hypertensive disorders of pregnancy in Indian women: a pilot study

Cited by 17 publications

References 37 publications

Cystatin C as a novel predictor of preterm labor in severe preeclampsia

Cystatin C as a novel predictor of preterm labor in severe preeclampsia

Increased Uric Acid, Gamma-Glutamyl Transpeptidase and Alkaline Phosphatase in Early-Pregnancy Associated With the Development of Gestational Hypertension and Preeclampsia

Hyperemesis Gravidarum: A Review of Recent Literature

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