Hypertension, Pregnancy-Induced Clinical Trial
Official title:
Evaluation of Kidney Injury Biomarkers in Women Suffering From Preeclampsia
we found different pattern of podocyte glycoproteins and kidney injury biomarkers in urine specimens between preeclampsia and pregnancy complicated with chronic hypertention compared with normotensive pregnant controls.abnormally elevayed urine biomarkers in severe preeclampsia were completely or prtially reduced 6-8 weaks after delivery to levels comparable with those of normal pregnant subjects.
Study design:
- Type of the study: Aprospective cross sectional study .All patients will be enrolled in
the study after obtaining a written consent.
- Setting: This study will be carried in the Emergency room of Assiut university Hospital
&Luxor International Hospital
Statistical Methods:
Inclusion criteria:
- the presence of informed consent
- Prim gravid or multi gravid <5
- age:18-35 ys
- Singleton pregnancy with gestational age >34weeks.
Exclusion criteria:
- Serious maternal illness.
- Smokers
- women with pregnancy complicated by nephritic syndrome, diabetic mellitus, or
gestational diabetes
- women known to have renal disease
- oliguria
- Methods :
200 patients with severe peclampsia will be recorded in Assiut university hospital and
luxor international hospital in aperiod of 6 months initial assessement: Blood pressure
will be measuerd in ER urine analysis will be done in ER by Urine Dipstick Analysis 40
cases will be randomized selected where urine sample will be collected to analyze the
markers to be studied
The women will be subjected to the following:
1. Detailed history taking
2. Clinical examination:
1. General examination: pulse, temperature, blood pressure, body weight and height,
body mass index.
2. Abdominal examination.
3. obestetric Ultrasonography to calculate gestational age,viability , amniotic fluid
,placental site and to exclude any congenital malformation.
4. Assessemet of renal function :urine output,blood urea,serum creatinine, u/s
5. All routine investigations: C.B.C., Rh, blood grouping, kidney functions tests, liver
enzymes.
6. sample collection : Freshly obtained urine specimens were centrifuged at 1,500 rpm for
10 min within 30 min of collection, aliquoted, and stored at _70°C until assayed.
Dipstick detection for urine protein, pH, and gravity. Urine protein, pH, gravity, etc.
were detected by Dipstick (Uri-Trak-3) in all urine specimens before being aliquoted for
storage at _70°C. Urine protein was positive for all study subjects in mild and severe
preeclamptic groups.
Biomarkers evaluated in urine specimens including podocyte glycoproteins nephrin and
podocalyxin, All biomarkers were measured by ELISA. Assay information for sources of ELISA
kits, standard cure range, sample dilution factors, etc.
All assays will be performed following the manufacture's instructions. All specimens will be
measured in duplicate.
Personnel who performed the assays of analyteswere blinded to the clinical information.
6. postnatal visits: Postnatal investigation, monitoring and treatment (including after
discharge from critical care) Blood pressure
Weekly till the end of puerperium.the postatal visits will iclude:
- Measurement of blood pressure
- U/S kidney
- Askig about urinary symptoms as amout of urine ,colour of urine ,and burning sensation.
Postnatal care will be done according to NICE clinical guidelines at the nearby patients
health care centre .the patients will be handed on information sheet containing instructions
about postnatal care. the patients will be followed up by telephone to report any
abnormalities that may occur
;
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