The Addis Sediment Count and Blood Urea Clearance Test in Normal Pregnant Women

Elden, C. A.; Cooney, Joseph

doi:10.1172/jci100738

Cited by 16 publications

(3 citation statements)

References 11 publications

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“…Prior attempts to quantify normal amounts of proteinuria in pregnancy were limited by small sample sizes, the inclusion of patients with hypertension, and the use of various methodologies for determining proteinuria. [6][7][8][9] More rigorous attempts at defining pregnancy-associated proteinuria followed when Kuo et al measured proteinuria in normal pregnant women. 10 They found the 99th percentile for proteinuria was 300 mg/24 h at 17 to 20 weeks and just below 200 mg/24 h at 33 to 36 weeks.…”

Section: Commentmentioning

confidence: 99%

Examination of Prepregnancy and Pregnancy Urinary Protein Levels in Healthy Nulliparous Women

et al. 2017

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During pregnancy, abnormal proteinuria is defined as urine protein excretion greater than 300 mg/24 h. Although widely accepted, this definition is not based on clinical outcomes. Our study aimed to longitudinally examine proteinuria in healthy women prior to, and in late pregnancy and to compare inpatient and outpatient 24-hour urine collections. Nulliparous women planning to conceive were recruited and completed a 24-hour urinary collection. Those who subsequently conceived completed a second 24-hour urinary collection in late pregnancy. In the first 5 years of the study, urinary collections were completed during an inpatient admission; all collections during the latter part of the study were performed as outpatients. Urine protein was measured using the VITROS UPRO Slide kit. Wilcoxon signed rank tests were used for paired comparisons of prepregnancy and late pregnancy proteinuria and Wilcoxon rank sum tests were used to compare inpatient and outpatient collections. Among 134 women completing a prepregnancy collection, median urinary protein excretion was 188 mg/24 h (IQR 103-280). Sixty-five women subsequently conceived and completed a late pregnancy collection. In healthy women, urinary protein increased to 254 mg/24 h during pregnancy (IQR 166-396). Forty-five percent of women exceeded the defined normal threshold of proteinuria in 24 hours in the absence of disease. Inpatient collections resulted in higher levels of urinary protein than outpatient at both time points. Our data suggest that significant proteinuria is present in healthy nonpregnant women. Even in the absence of disease, proteinuria increases during pregnancy. Outpatient collections may underestimate proteinuria, especially in late pregnancy.

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Section: Commentmentioning

confidence: 99%

Examination of Prepregnancy and Pregnancy Urinary Protein Levels in Healthy Nulliparous Women

et al. 2017

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“…It may, however, be of practical importance in distinguishing between a high normal count and a low-grade but pathological increase; for instance, after healing of a glomerulonephritis or pyelonephritis, or in the diagnosis of latent renal disease (Rew and Butler, 1932;Lyttle, 1933 ;Boyle et al, 1937;Snoke, 1937Snoke, , 1938Hamburger et al, 1950;Richet, 1953;Milliez and Lagrue, 1955;Merker and Kerp, 1958;Winter, 1958). Augmentation of these cells is reported in conditions in which no other renal involvement-for example, during fever in rheumatoid arthritis (Goldring and Wyckoff, 1930), pneumonia (Goldring, 1931), pregnancy (Elden and Cooney, 1935), scarlet fever (Lyttle, 1933), vigorous exercise (Roberts, 1935)-as well as after different treatments (Harvald et al, 1960;Clausen and Harvald, 1961).…”

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confidence: 99%

Quantitative Estimation of Urinary Sediment, with Special Regard to Sources of Error

Gadeholt¹

1964

BMJ

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“…The above tests with the routine procedures as previously outlined (1) were made on each of thirty-three patients on three occasions; during the acute phase of the toxemia prior to delivery, in the early puerperium and three or more months postpartum. This method of study was followed in order that the course of renal function could be studied with the possible end in view of an earlier and better prognosis and perhaps a more simple classification of the toxemias of pregnancy.…”

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The Effect of the Toxemias of Pregnancy on Renal Function

Elden¹,

Sinclair²,

Rogers³

1936

J. Clin. Invest.

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In a previous contribution (1) it was shown that there is a wider range of normal values for renal function tests in normal women in the last trimester of pregnancy than in normal non-pregnant individuals. The blood urea clearance (2) was shown to vary between 60 and 118 per cent of normal. The total protein content of the urine was within normal limits. The urinary sediment count of Addis (3) showed the casts to vary from 0 to 10,000, the red blood cells to range from 47,000 to 1,900,000 and the white blood and epithelial cells to vary from 25,000 to 6,000,000. These are the values which must be used for comparison when interpreting the results of renal function tests during the acute phase of the toxemias of pregnancy. When the patient has returned to her normal non-pregnant level, some three months postpartum, comparison can be made with the usual normal values established by Van Slyke and Addis.The above tests with the routine procedures as previously outlined (1) were made on each of thirty-three patients on three occasions; during the acute phase of the toxemia prior to delivery, in the early puerperium and three or more months postpartum. This method of study was followed in order that the course of renal function could be studied with the possible end in view of an earlier and better prognosis and perhaps a more simple classification of the toxemias of pregnancy. The cases studied have been divided into three groups; (I) preeclampsia including all types from the mild to the more severe; (II) eclampsia; and (III) nephritis complicating pregnancy. The results are shown in Tables I, II and III (Table I) This group includes twenty cases of preeclampsia varying from the milder forms with elevated blood pressure and albuminuria to those verging on eclampsia. They are about equally divided between the two subgroups. There was no history of nephritis in any of the cases. In nine of the twenty cases there was a history of a previous preeclampsia. The cases with a history of a previous toxemia are about equally divided between the two subgroups and are identified by an asterisk under the case number. In two of the cases with previous preeclampsia the recent clinical course was sufficiently severe and the renal function sufficiently impaired to warrant termination of the pregnancy. Both of these cases (52767 and 59342) have sustained definite renal injury.Considering the renal function of this group as a whole it will be noted that during the acute phase the blood urea clearance is for the most part normal. In three cases it was below 60 per cent of normal, the lower normal limit during the last trimester of pregnancy. During the puerperium little change in the blood urea clearance was observed. In the period three or more months postpartum, however, there were four of the nine cases with possible renal damage in which the blood urea clearance was below the lower limits established by Van Slyke. The values obtained were sufficiently low to indicate renal injury.The degree of proteinuria (4) is of no marked diagnost...

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The Addis Sediment Count and Blood Urea Clearance Test in Normal Pregnant Women

Cited by 16 publications

References 11 publications

Examination of Prepregnancy and Pregnancy Urinary Protein Levels in Healthy Nulliparous Women

Examination of Prepregnancy and Pregnancy Urinary Protein Levels in Healthy Nulliparous Women

Quantitative Estimation of Urinary Sediment, with Special Regard to Sources of Error

The Effect of the Toxemias of Pregnancy on Renal Function

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