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Hypocalciuria in preeclampsia.

P A Taufield, K L Ales, L M Resnick

    The New England Journal of Medicine
    |March 19, 1987
    PubMed
    Summary
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    Preeclampsia is linked to significantly lower urinary calcium excretion, a key indicator distinguishing it from other hypertensive disorders in pregnancy. This finding suggests increased calcium reabsorption in the kidneys of preeclamptic women.

    Area of Science:

    • Obstetrics and Gynecology
    • Nephrology
    • Biochemistry

    Background:

    • Preeclampsia is a serious pregnancy complication characterized by high blood pressure.
    • Distinguishing preeclampsia from other hypertensive disorders is crucial for appropriate management.
    • Alterations in calcium metabolism have been implicated in preeclampsia pathogenesis.

    Purpose of the Study:

    • To investigate whether serum calcium levels or urinary calcium excretion can differentiate preeclampsia from other gestational hypertensive conditions.
    • To explore the relationship between calcium handling and preeclampsia.

    Main Methods:

    • Studied 40 pregnant women in their third trimester, including normal pregnancies, transient hypertension, chronic hypertension, chronic hypertension with superimposed preeclampsia, and preeclampsia.

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  • Measured serum levels of ionized calcium, phosphate, and 1,25-dihydroxyvitamin D.
  • Assessed 24-hour urinary calcium excretion and fractional excretion of calcium.
  • Evaluated creatinine clearance.

    • Main Results:

    • No significant differences in serum calcium, phosphate, or 1,25-dihydroxyvitamin D levels were observed among the groups.
    • Significantly lower 24-hour urinary calcium excretion was found in women with preeclampsia (42 mg) and superimposed preeclampsia (78 mg) compared to normal (313 mg), transient hypertension (248 mg), and chronic hypertension (223 mg) groups.
    • Hypocalciuria in preeclampsia was associated with decreased fractional calcium excretion, despite overlapping creatinine clearance values.
    • Urinary calcium excretion showed minimal overlap between preeclampsia and other groups, unlike creatinine clearance.

    Conclusions:

    • Preeclampsia is associated with hypocalciuria, likely due to increased renal tubular reabsorption of calcium.
    • Urinary calcium excretion measurement may serve as a valuable tool for differentiating preeclampsia from other forms of gestational hypertension.