THE CHANGES OF RENAL FUNCTION STATUS BASED ON PROTEINURIA AND GLOMERULUS FILTRATION RATE IN PATIENTS WITH HISTORY OF PREECLAMPSIA WITH SEVERE FEATURES

Author:

Adilla Ardy Chairul1,Panusunan Lubis Muara2,Adeya Adella Cut3,Partogi Pasaribu Hotma2,Rusda Muhammad4,Rizki Yaznil Muhammad5

Affiliation:

1. Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

2. Division of Fetomaternal, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

3. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, FacultyofMedicine,UniversitasSumateraUtara,Medan,Indonesia

4. Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia

5. Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Universitas Sumatera Utara, Medan, Indonesia.

Abstract

Background: Preeclampsia with severe features is an endothelial disease that causes renal system disorders during pregnancy. Preeclampsia is an important cause of acute kidney injury and risk for chronic kidney disease. Methods: This study was a case series conducted at the Department of Obstetrics and Gynecology, H. Adam Malik General Hospital Medan, Indonesia starting from December 2019 until January 2020. Total sampling technique was employed obtaining 31 subjects with a history of preeclampsia with severe features for at least 3 months to 2 years postpartum, without a history of chronic disease, diabetes mellitus, and congenital kidney disorders. Proteinuria, serum creatinine, and GFR calculations were performed. Results: There were 31 patients who met the inclusion and exclusion criteria. At a time interval of 4 - ≤13 months postpartum, 2 levels of proteinuria +1 (0-2), serum creatinine 0.81 ± 0.21 mg/dl, and levels of GFR 109.57 ± 25.13 (ml/min/1.73 m ). Whereas at the time interval of >13 - 24 months postpartum, levels of proteinuria +1 (0-3), serum creatinine 0.85 ± 0.23 mg/dl, and GFR 2 levels of 104. 41 ± 28.45 (ml/min/1.73 m ). The mean of serum creatinine before delivery was 0.69 ± 0.15 mg/dl and after delivery was 0.83 ± 0.22 mg/dl. The mean of GFR postpartum at group of history of early onset preeclampsia was 103.07 ± 25.23 2 2 (ml/min/1.73 m ) and group of history of late onset preeclampsia was 113.40 ± 28.24 (ml/min/1.73 m ). Conclusion: There was a tendency for a decrease in renal function among women with a history of preeclampsia with severe features with ndings of persistent proteinuria from more than 3 to 24 months postpartum, an increase in mean of serum creatinine levels from before and after delivery and a decrease in GFR, but it was not signicant. This was related to the slow course of chronic kidney disease, so it had to be followed up periodically.

Publisher

World Wide Journals

Reference25 articles.

1. World Health Organization. Trends in maternal mortality: 2000 to 2017: estimates by WHO, UNICEF, UNFPA, World Bank Group, and the United Nations Population Division. 2019.

2. Djannah SN, Arianti IS. Gambaran epidemiologi kejadian preeklampsia/eklampsia di RSU PKU Muhammadiyah Yogyakarta Tahun 2007-2009. Buletin Penelitian Sistem Kesehatan. 2010 Oct 4;13(4):378-85.

3. Achadi EL. Kematian maternal dan neonatal di indonesia. Rapat Kerja Kesehatan Nasional Kementerian Kesehatan RI. Tangerang. 2019;13.

4. Lafayette R. The kidney in preeclampsia. Kidney international. 2005 Mar 1;67(3):1194-203.

5. IE S. Karumanchi SA. The glomerular injury of preeclampsia. J Am Soc Nephrol. 2007;18(8):2281-4.

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