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子痫前期女性的肾脏评估

Renal evaluation in women with preeclampsia.

作者信息

Facca T A, Kirsztajn G Mastroianni, Pereira A R, Moreira S R, Teixeira V P C, Nishida S K, Sass N

机构信息

Disciplines of Obstetrics and Nephrology of the Federal University of São Paulo (UNIFESP), São Paulo, Brazil.

出版信息

Nephron Extra. 2012 Jan;2(1):125-32. doi: 10.1159/000338271. Epub 2012 May 22.

Abstract

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.

摘要

背景/目的:先兆子痫(PE)是全球范围内肾小球病的一个病因。尿视黄醇结合蛋白(RBP)是近端肾小管功能障碍的标志物,蛋白尿是内皮损伤标志物,尿蛋白:肌酐比值(PCR)可能对日后的肾脏疾病具有预测价值,并且最近,足细胞尿已被提议作为孕期的一种敏感检测指标,但仍需进行验证。本研究的目的是评估PE和健康妊娠中的肾脏受累情况。

方法

采用病例对照研究,对39名妊娠20周后接受评估的孕妇(对照组25名,PE组14名)进行尿液检测。

结果

对照组的平均(±标准差)年龄和孕周分别为26.9±6.4岁和37.1±5.0周,PE组分别为26.4±6.9岁和30.6±5.6周(p = 0.001)。对照组的平均(±标准差)尿RBP(p = 0.017)、蛋白尿(p = 0.002)和尿白蛋白浓度(UAC)比值(p = 0.006)分别为0.4±0.7mg/l、7.3±6.9mg/l和8.2±6.7mg/g,PE组分别为2.0±4.4mg/l、2267.4±2130.8mg/l(p = 0.002)和3778.9±4296.6mg/g(p = 0.006)。PE组的平均(±标准差)尿PCR为6.7±6.1g/g(p < 0.001)。对照组和PE组的足细胞尿之间未发现统计学差异(p = 0.258)。

结论

与对照组相比,PE组的尿RBP、PCR、蛋白尿和UAC比值升高。足细胞尿不能预测PE。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/22d3/3383241/b52519d91892/nne-0002-0125-g01.jpg

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