Title: Evaluation of Urinary Calcium – Creatinine Ratio in Pre-Eclampsia-A Study from Kerala, Southern India
Authors: Dr Fouiza.B, Nishitha P.A, Mr. Prabhachandran P
DOI: https://dx.doi.org/10.18535/jmscr/v5i3.94
Abstract
Background: Hypertensive disorders still continues to be a major killer of mothers around the globe. Its complex pathophysiology starting with abnormal placentation with endothelial dysfunction, still remains unclear. This study aims to know alteration in serum and urinary calcium levels in cases of Gestational Hypertension and Pre-eclampsia. Primary objective was the evaluation of urinary calcium and creatinine excretion levels and find out calcium-creatinine ratio in patients with Gestational Hypertension and pre-eclampsia and compare it with normal pregnant women.
Method: 54 Gestational hypertensive cases and 54 normal pregnant women were included in the study based on inclusion and exclusion criteria. Urinecalcium and creatinine and serum uric acid, total protein, albumin and serum sodium were estimated in corresponding samples collected from patients. Urinary calcium was estimated by Arsenazo method and creatinine by modified Jaffe’s method.
Result: It was found that urinary calcium was decreased in both pre-eclampsia and gestational hypertensive patients compared with the controls, and a significant decrease is seen in urine CCR. The CCR had a sensitivity and specificity of 90.9% and 76.7% respectively.
Conclusion: Decreased urinary calcium excretion in pre-eclampsia and pregnancy induced hypertensives compared to normal pregnant women found to be significant and urine CCR is significantly decreased in pre-eclampsia patients compared to pregnancy induced hypertensives.
Keywords: GHTN, PET, BMI, Hypocalciurea, CCR.
References
1. Canningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstra Willi p L, Wenstrom KD. Williams Obstetrics, 22nd edn. Beng-aluru, Karnataka, McGraw Hill, 2005.
2. Barker P, Kingdom J, Pre-eclampsia: Curr-ent Perspective and Management, ist Edn. Canada: RCOG Press, 2004, pp, 25-35.
3. Park k Park,s Textbook of preventive and Social Medicine, 23rd exn.Jabalpur, Banarsidas Bhanot. 2005.pp 558-560.
4. Prakash J, Pandey LK, Singh AK, Kar B. Hypertension in Pregnancy: hospital based study. J Asspc physicians India 2006;54:273-8
5. Halhali A, Diaz L, Avila E, Ariza AC, Garabedian M, Larrea F. Decreased fractional urinary calcium excretion and serum, I, 25 – dihydroxyvitamin D and IGF – Levels in preeclampsia J steroid Biochem Mol Biol 2007; 103 (3 – 5): 803 – 6
6. Kanagal DV, Rajesh A, Rao K, Devi UH, Shetty H, Kumari S, et al Levels of serum calcium and magnesium in pre-eclamptic and normal pregnancy: a study from coastal India. Jo Clin Diagn Res 2014;8(7) OC04-8.
7. Taufield PA, Ales KL, Resnick LM et al: Hypocalciuria in preeclampsia. N Engl J Med 1987;316: 715-718
8. Rodriguez MH, Masaki D I, Mestman J et al. Calcium/cretatinine ratio and microakbuminuria in the prediction of pre eclampsia. Am J Obstet Gynaecol 1988; 159:1452 – 55.
9. Dasgupta Mandira, Adhikari Sudhir, Sanghamita Mamtaz. Urinary calcium levels in pre-eclampsia. Department of Obstetrics and Gynaecology Eden hospital, Medical College and Hospitals, 88, College Street, Kolkata – 700 073: J Obstet Gynecol India Vol. 58, No.4: July/August 2008 p: 312.
10. Kazerooni S and Hamze – Nejadi S, Calcium to creatinine ratio in a spot sample of urine for early prediction of preeclampsia. Intl J Gynecol Obstet. 2003;80: 279-83.
11. Indu Prasad, Bandana Kumari, Achal Narayan roy, Pritam Prakash. Evaluation of Urinary Calcium Creatinine Ratio in pre Eclampsia.www.njlm.jcdr.net. DOI:NJLM/2016/17110:2012.
12. Sheela C N et.al, Calcium creatinine ratio and microalbuminuria in prediction of pre – eclampsia. Journal of Obstetrics and Gynecology of India. 2011: 72-76.