Title: Urinary Calcium to Creatinine Ratio in Preeclampsia – a Comparative Study

Authors: Dr Anita V, Dr Adma Harshan S

 DOI:  https://dx.doi.org/10.18535/jmscr/v5i6.128

Abstract

Aim: An investigation To study whether urinary calcium and calcium to creatinine ratio are decreased in pregnant patients with preeclampsia.

Material & Methods: The study was conducted in Sree Avittom Thirunal Hospital, Thiruvananthapuram, during a period of seven months. A total of 100 patients were included in the study out of which 50 were preeclamptic patients and (group 1) another 50 belonged to normo tensive group (group 2). The study group were all primi gravidas, in their third trimesters, on unrestricted diet and with no history of diabetes or renal diseases. Estimation of urinary calcium and creatinine was done at bio-chemistry laboratory of the same hospital. Relevant history like age, socio-economic status, mean arterial pressure, family history of hypertension and history of passive smoking were also collected. Data collected were entered into a master chart and statistical packages were used to compute significance.

Results: Urinary calcium to creatinine ratio was significantly reduced (tvalue 3.57, p 0.0005) in preeclampsia patients as compared to normotensive group. Mean arterial pressure, family history of hypertension and history of passive smoking had no significant association with occurence of preeclampsia in pregnancy.

Conclusion: This study confirms hypo calciuria and decreased urinary calcium to creatinine ratio in preeclampic patients. The mechanism is not well established. The ratio can be used as a predictive tool for development of preeclampsia in pregnancy. Mean values of calcium excretion obtained in this study are lower than that in various other studies. This may be due to dietary deficiency of calcium. 

 

Keywords- Preeclampsia, hypo calciuria, calcium to creatinine ratio, hyper tension.

References

          1.      Norwitz, Errol R.; Robinson, Julian N.; Repke, J  Prevention of Preeclampsia: Is It Possible?, J. Clinical Obstetrics and Gynaecology, 1999; 42 (3), 445-449

2.      Rodriguez JG, Avendano R, Austral de Chile, Valdivia Braz Jr Med Biol Res. Hypocalciuria in pre eclampsia (Article in Spanish) 1998; (4):519-22.

3.      Suarez VR, Trelles JG, Miyahira JM. Urinary calcium in asymptomatic primigravida who later developed preeclampsia. J Obstet Gynecol. 1996 ; 87:79–82.

4.      Xie Y, Zhang G Liu X, Qiu W, (Article in Chinese) Urinary calcium excretion in patients with pregnant hypertension syndrome Hua Hsi I Ko Ta Hseuh Hseuh Pao 1995 Mar; 26(l):94-7.

5.      Ramos L. S, Sandroni S, Andrez FT Calcium excretion in preeclampsia Obstet Gynecol 1991 Apr;77(4):510-3

6.      Barton JR, Mercer BM Sibai BM, The effect of Nifedipine on urinary excretion of calcium in pre eclampsia American journal of Perinatology 1997 Nov;14(10):609-12

7.      Suzuki Y, Hayashi Y, Murakami I Urinary calcium excretion as an early prediction marker for pregnancy induced hypertension (Article in Japanese) Nippon Sanka Fujinka Gakkai Zasshi 1992 Nov, 44(11)1421-6

8.      Raniolo E, Phillipou G Prediction of pregnancy induced hypertension by means of the urinary calcium to creatinine ratios Med J Aust 1993 Jan 18;158(2) 98-100.

9.      Baker PN, Hackett GA, The use of urinary albumin creatinine ratio and calcium creatinine ratio as screening tests for pregnancy induced hypertension Obstet Gynecol 1994;83(5) 745-9

10.  Attalah AN, Hofmeyr GJ Duley L Calcium supplementation during pregnancy for preventing hypertensive disorders and related problems Cochrane Database Syst Rev 2000;(3) CD001059.

11.  Taufield P A, Ales K I, Resnick L,Druzin ML N,Hypocalciuria in pregnancy New Eng J med 1987;316:715-718S. M. Metev and V. P. Veiko, Laser Assisted Microtechnology, 2nd ed., R. M. Osgood, Jr., Ed.  Berlin, Germany:  name of the journal, 1998.

Corresponding Author

Dr Anita V.

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