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Evaluation of urinary calcium–creatinine ratio as a diagnostic tool in the management of preeclampsia

Vivaan Dutt, Nirmitha M Dev.




Abstract

Background: Preeclampsia has a complex pathophysiology in which several studies have reported derangement in calcium metabolism. The decrease in urinary calcium and calcium–creatinine ratio (CCR) could be considered as a risk factor for development of preeclampsia. This ratio is easily measurable, most effective even with spot urine sample.

Objective: To study the levels of urinary CCR and to correlate with proteinuria in preeclamptic patients and to assess the role of CCR in urine as a diagnostic marker in preeclampsia.

Materials and Methods: This cross-sectional study was carried out in 30 cases of pregnant women diagnosed with preeclampsia and 30 age-matched controls in MS Ramaiah Teaching Hospital, Bangalore over a period of 2 months. Random urine samples were collected from the cases and controls, and urinary calcium, creatinine, and protein were measured using their corresponding methods. The urinary CCR was studied and correlated with proteinuria. All the quantitative variables were described in terms of mean and standard deviation. The differences in the mean values between cases and controls were tested through Student’s t-test or oblique propriate nonparametric test of significance. To test for differences in the proportion between cases and controls, X2 test of significance was employed.

Result: It was found that urinary calcium was significantly increased in cases compared with the controls, whereas there was no significant difference in CCR. The CCR had a sensitivity and specificity of 40% and 86.67%, respectively.

Conclusion: Although significant numbers of pregnant women with gestational hypertension and preeclampsia did not have decreased ratio, the urinary calcium levels had decreased in preeclamptic patients.

Key words: Calcium–creatinine ratio, proteinuria, preeclampsia, hypocalciuria






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