Proteinuria Clinical Trial
Official title:
Quantitating Proteinuria During Acute Pyelonephritis In Pregnancy
The purpose of this research study is to compare the amount of protein excreted by the kidneys in a 24-hour period between patients who have a kidney infection and those who do not have a kidney infection.
Preeclampsia is a pregnancy-unique disorder that is cured only with delivery of the baby,
even if the pregnancy is premature. Defined by both blood pressure and proteinuria criteria,
diagnosis is often obscured by renal processes like systemic lupus erythematosus or nephrotic
syndrome that increase urinary protein spillage. Proteinuria is defined as a total protein
urinary excretion exceeding 300 mg in a 24-hour urine collection in pregnancy. This is
suggested to be double the protein excretion in the non-pregnancy population at 150 mg/day. A
mean 24-hour urine protein excretion of 204.3 mg (± 92.5) was found in the non-hypertensive
pregnant population.
Physiological changes in pregnancy predispose patients to urinary tract infections; ureteral
compression by the gravid uterus, progesterone-mediated slowing of ureteral peristalsis and
decreased bladder tone, and mechanical compression of the bladder contribute to impaired
clearance of bacteria from the urinary tract. Indeed, acute cystitis complicates 2-4% of all
pregnancies. While it has been said that urinary tract infections increase proteinuria, it is
unknown how much protein spillage should be expected in the general or the pregnant
populations. Hence a patient with pyelonephritis may obscure the diagnosis of preeclampsia if
she spills urinary protein from her infection.
The purpose of this study is to compare the mean of 24-hour urine protein in pregnant
patients with and without acute pyelonephritis.
The importance of this study will be to determine if urine protein excretion is in fact
increased in the setting of pyelonephritis. This will allow for reliable evaluation of urine
protein during the work up for preeclampsia in those women also found having a kidney
infection.
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