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Renal evaluation in women with preeclampsia
T A Facca1, G Mastroianni Kirsztajn, A R Pereira
1Disciplines of Obstetrics and Nephrology of the Federal University of São Paulo (UNIFESP), São Paulo, Brazil.
Insights
Preeclampsia (PE) is linked to kidney damage, indicated by elevated urinary retinol-binding protein (RBP) and albuminuria. Podocyturia, however, did not show predictive value for PE in this study.
Area of Science:
- Nephrology
- Obstetrics
- Biomarkers
Background:
- Preeclampsia (PE) is a significant global cause of glomerulopathy.
- Urinary markers like retinol-binding protein (RBP) for tubular dysfunction and albuminuria for endothelial injury are crucial in assessing kidney involvement.
- The predictive value of urine protein:creatinine ratio (PCR) and podocyturia in pregnancy requires further investigation.
Purpose of the Study:
- To evaluate renal involvement in pregnancies complicated by preeclampsia (PE) compared to healthy pregnancies.
- To assess the utility of urinary retinol-binding protein (RBP), albuminuria, urine protein:creatinine ratio (PCR), and podocyturia as markers of renal dysfunction in PE.
Main Methods:
- A case-control study was conducted with 39 pregnant women (14 with PE, 25 controls) after 20 weeks of gestation.
- Urinary tests were performed to measure retinol-binding protein (RBP), albuminuria, urine protein:creatinine ratio (PCR), and podocyturia.
Main Results:
- Women with PE exhibited significantly higher levels of urinary RBP, albuminuria, and urinary albumin concentration (UAC) ratio compared to the control group.
- The urine protein:creatinine ratio (PCR) was also significantly elevated in the PE group.
- No statistically significant differences in podocyturia were observed between the PE and control groups.
Conclusions:
- Urinary RBP, albuminuria, UAC ratio, and PCR are elevated in preeclampsia, indicating renal involvement.
- Podocyturia did not emerge as a predictive marker for preeclampsia in this study.
Background/Aims:
Preeclampsia (PE) is a cause of glomerulopathy worldwide. Urinary retinol-binding protein (RBP) is a marker of proximal tubular dysfunction, albuminuria is an endothelial injury marker, urine protein:creatinine ratio (PCR) may have a predictive value for renal disease later in life, and, recently, podocyturia has been proposed as a sensitive tool in pregnancy, but it needs to be tested. The aim of this study was to evaluate renal involvement in PE and healthy pregnancy.
Methods:
Case-control study with 39 pregnant women assessed after 20 weeks of gestation (25 in the control group, CG, and 14 in the PE group) by performing urinary tests.
Results:
Mean (±SD) age and gestational age of the CG were 26.9 ± 6.4 years and 37.1 ± 5.0 weeks, and of the PE group 26.4 ± 6.9 years and 30.6 ± 5.6 weeks, respectively (p = 0.001). Mean (±SD) urinary RBP (p = 0.017), albuminuria (p = 0.002), and urinary albumin concentration (UAC) ratio (p = 0.006) of the CG were 0.4 ± 0.7 mg/l, 7.3 ± 6.9 mg/l, and 8.2 ± 6.7 mg/g and of the PE group 2.0 ± 4.4 mg/l, 2,267.4 ± 2,130.8 mg/l (p = 0.002), and 3,778.9 ± 4,296.6 mg/g (p = 0.006), respectively. Mean (±SD) urine PCR in the PE group was 6.7 ± 6.1 g/g (p < 0.001). No statistical differences were found between podocyturia in the CG and PE group (p = 0.258).
Conclusions:
Urinary RBP, PCR, albuminuria, and UAC ratio were elevated in the PE group in comparison to the CG. Podocyturia did not predict PE.
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