Serum cr (scr) a tool for assessing kidney status in pregnancy induced hypertension?

Affi Ayuba¹ , Imoh Lucius¹ , Longwap S.A¹ , Alfred Odo¹ , Solomon Luka Mercy¹ , Anzaku A²

¹Department of Chemical Pathology, University of Jos, Plateau, Nigeria

²Department of Anatomical Pathology, Jos University Teaching Hospital, Jos, Plateau, Nigeria

Corresponding Author Email: ayubaaffi67@gmail.com

DOI : https://doi.org/10.51470/eSL.2025.6.1.26

Abstract

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Introduction

Approximately  about 20% of the cardiac output circulates through the kidneys. As the blood passes through each glomerulus, a portion is filtered at the glomerular filtered  rate (GFR). GFR decreases with age, and can be estimated from the Cockcrofi-Gault relationship: [1]Serum creatinine is defined as a biochemical marker used to assess kidney function, with its biological variation influencing the estimation of the biological variation of the estimated glomerular filtration rate (eGFR). It serves as a critical input  in the calculation of eGFR through established equations.Serum creatinine remain the standard biomarker for kidney function in pregnancy, but b=normal level change day………..[2]

The determination of renal function before and during pregnancy has clinical importance: kidney disease can affect maternal and prenatal health. Glomerular hyperfiltration is a typical physiological adaption to pregnancy, reflected by a decrease in levels of serum creatinine (SCr) with advancing gestational age. A 24 – hour collection of urine to measure creatinine clearance is impractical. Accordingly, physicians typically rely on (SCr) level. PIH Pregnancy induced hypertension is a disorder of pregnancy characterized by the onset of high blood pressure and may lead to kidney disease [3].PIH increases the risk of poor outcomes for both the mother and the baby (if left untreated, it may result in seizures at which point is known as PIH represents an important cause of maternal as well as prenatal morbidity and mortality.The excessive activation of inflammatory or other systems lead to immune system disorders and the deposition of an overdose of immune complexes in the kidney, which increase vascular permeability to a certain degree and impair the kidney function. An assessment of kidney function is therefore necessary for adequate function of kidney in gestation function found in patients with hypertensive disorder complicating pregnancy is impaired [4].

Serum (blood) creatinine is a very common test, A “normal” creatinine level as reported in their laboratory result may actually have kidney disease. The opposite can also be true  – some people with a  “high” creatinine level may not have kidney disease, or it may be less severe than it seems. To know how well your kidney are working is to look at your estimated glomerular filtration rate (eGFR). eGFR is calculated using your serum (blood) creatinine level, age and sex [5 and 6]. SCr through pregnancy may be associated with adverse pregnancy outcome. Hence the utility of creatinine monitoring to predict pregnancy out comes warrant further investigation.

Subjects and Methods

• Study design

This is a retrospective descriptive study conducted using edictal records of 138 Ante natal clinic (ANC) women who attended the metabolic clinic of chemical pathology department JUTH Jos University Teaching Jos, Plateau State  between the months of January 2024 and December 2024.

Results

This result presents findings from the analysis of patients’ clinical date focusing on creatinine Serum Creatinine (SCr),  Blood pressure (BP).

Data set Summary

Creatinine (Cr)

• Average Cr: 63.17
• Minimum Cr: 7
• Maximum Cr: 95

Uric Acid (U/A)

Creatinine level classification (Cr threshold = 77 umol/L)

• Normal range creatinine  (Cr7-77 umol/L) 106 patients
• High creatinine (Cr>77 umol/L ): 21 patients
• The majority of patients (106 out of 127) had creatinine values within the normal range.
• A smaller group (21 patients) had elevated creatinine level, indicating potential renal damage.

Combined Risk Classification (creatinine and BP)

To identity higher-risk patients, a combined condition was applied:

High creatinine: Cr>77

High BP: BP  130/90 nmol/L

• Patients with Cr > 77  AND BP  130/90  mmHg:9 patients
• Patients with Cr  > 77 AND BP < 130/90mmHg: 69 Patients

Summary

1. Creatinine levels:
2. 106 Patients without kidney damage creatinine
3. 21 Patients had high creatinine (>77) umol/L
4. :9 Patients had both high creatinine (> 77 umol/L) and high BP (>130/90 mmHg).

Discussion

The results obtained shows high risk patients with creatinine SCr 77umol/L with hypertension  function can be asuspected when serum Cr concentration rises to 77 umol/L. Compared to UK recommendation that abnormal kidney limit. In this study of pregnant women mean SCr concentration was found to be 63.17 mmol/L and blood pressure was found to be ¹³⁰/₉₀ mmHg. In another study the mean SCr of pregnant women was found to be SCr = 84.5 which was higher than for this study. The higher SCr in our study 7 was be because there in Hypertension and higher sample size. The utility of SCr monitoring to predict pregnancy outcomes will warrant further investigation.

REFERENCES

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