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Background: Hypertension in pregnancy is a big threat to the mother as well as the fetus. Prediction of preeclampsia with reasonable accuracy is one of the essential prerequisites for its prevention. Various biological markers are available for the prediction of preeclampsia but none of those is reasonably reliable, valid and economical. In this present study, the predictive value of the urinary calcium-creatinine ratio (CCR) for the prediction of preeclampsia was studied.Methods: This Prospective, observational study was conducted in the department of obstetrics and gynecology, Jawaharlal Nehru Hospital, Bhilai, Chhattisgarh, India. The study population was comprised of consecutive 174 pregnant women with gestational age between 20-28 weeks attending antenatal OPD. Calcium and creatinine levels were estimated in the midstream clean catch urine sample. After initial workup, all patients were followed in the antenatal clinic till the time of delivery. The number of patients who develop the hypertensive disorder in pregnancy was noted and the correlation studied.Results: On statistical analysis, CCR at ≤0.04 had a sensitivity of 71.43%, specificity of 98.75%, and the positive predictive value of 83.33% and negative predictive value of 97.53%. The accuracy of the test was 96.55%.Conclusions: A single estimation of calcium to creatinine ratio in asymptomatic pregnant women between 20-28 week of gestation is a simple and cost-effective test. A value of less than or equal to 0.04, in a spot urine sample, has a good predictive value for preeclampsia.
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PURPOSE: Urinary calcium creatinine ratio (UCaCrR) is a reliable indicator for monitoring hypercalciuria following vitamin D supplementation. However, the reference range varies from region to region. Previous studies did not take vitamin D and parathyroid hormone status into account while evaluating UCaCrR. Hence, we undertook this study to establish the 95th percentile of UCaCrR as an indicator of hypercalciuria in North Indian children and adolescents. METHODS: Four hundred seventy-three participants (boys 62.2%, girls 37.8%) with adequate dietary calcium intake, normal serum levels of 25-hydroxy-vitamin D (>20 ng/mL), and without secondary hyperparathyroidism following supplementation were selected for evaluation of UCaCrR. RESULTS: The mean age and body mass index of subjects were 11.2±2.6 years and 18.0±3.6 kg/m2, respectively. The 95th percentile of UCaCrR in the study population was 0.126. The mean, median, and 95th percentile of UCaCrR was significantly higher in prepubertal children (age ≤10 years) (0.0586±0.0374, median=0.0548, 95th percentile=0.136) compared to those >10 years old (0.0503±0.0363, median=0.0407, 95th percentile=0.123, P=0.02). No significant difference in UCaCrR was observed between genders and different weight categories. CONCLUSIONS: UCaCrR of 0.13 defines the cutoff value for hypercalciuria in North Indian children and adolescents with adequate dietary intake of calcium and sufficient serum vitamin D levels.
Subject(s)
Adolescent , Child , Female , Humans , Body Mass Index , Calcium , Calcium, Dietary , Creatinine , Hypercalciuria , Hyperparathyroidism, Secondary , Parathyroid Hormone , Reference Values , Vitamin DABSTRACT
Background:Pregnancy-induced hypertension (PIH) is a condition characterized by high blood pressure during pregnancy.It is the most common leading cause of maternal and perinatalmorbidity and mortality in females. Serum high sensitive C-reactive protein (hs-CRP) is one of the suitablemarkers for low grade inflammation evaluation.Urinary calcium-creatinine ratio (UCa/Cr) is a valuable marker for prediction of PIH Aim:To measure & correlate serum hs-CRP and urinary calcium-creatinine ratio in between pregnancy-induced hypertension and normal pregnancy.Material & Methods:In present study total 150 subjects attending Department of Obstetrics & Gynecology at Sir Takhtsinhji Hospital, Bhavnagar, Gujarat, were included which were categorized in two groups. Group A: 75 patients of pregnancy-induced hypertension; Group B: 75 normal pregnant women as a control group. They were primarily diagnosed based on measurement of bloodpressure, clinical examination followed by biochemical investigations like hs-CRP, urinary calcium & creatinine, RBS, urea, creatinine, uric acid, CK-MB. Written informed consent was obtained from all participants before enrolling in the study.Results:No significant change in the levels of biological parameters like RBS, urea, creatinine and CK-MB was observed in both the study groups (p>0.05) except serum uric acid shows a significant difference (p<0.001). The levels of hs-CRP were found to be significantly higher in patients of pregnancy-induced hypertension (7.81±3.681)as compared to the normal pregnant women (3.11±1.972)(p<0.0001) .UCa/Cr ratio had more sensitivity and specificity than hs-CRP for prediction of pregnancy-induced hypertension compared to normal pregnancy.Conclusion:UCa/Cr ratio can be used as a more sensitive and specific test to detect pregnancy induced hypertension
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INTRODUCCIÓN: la hipercalciuria constituye el principal trastorno metabólico en la litiasis urinaria. Su diagnóstico implica recolección de orina de 24 horas con riesgo de errores y se ha utilizado el índice calcio creatinina como marcador de hipercalciuria. OBJETIVOS: determinar la validez de este indicador como marcador de hipercalciuria. MÉTODOS: se realizó un estudio descriptivo, transversal por la importancia del diagnóstico de la hipercalciuria y los desacuerdos en la utilidad del índice calcio creatinina y su punto de corte óptimo. Se estudiaron 1603 sujetos litiásicos cubanos entre 2 y 19 años, a los que se les mensuró calciuria de 24 horas e índice calcio creatinina de la segunda orina de la mañana. RESULTADOS: se obtuvo correlación positiva moderada entre las variables. Para los valores de corte tradicionales del índice calcio creatinina, la sensibilidad fue 95,7 % y 81,9 %, y la especificidad 48,3 % y 66,7 %, para niños y adolescentes, respectivamente. CONCLUSIONES: el índice calcio creatinina es útil como prueba de despistaje poblacional de hipercalciuria, sin embargo para la confirmación diagnóstica se requiere ineludiblemente la mensuración de la calciuria por recolección de orina de 24 horas.
INTRODUCTION: hypercalciuria is the main metabolic disorder in urolithiasis. Diagnosis involves collecting urine for 24 hours with risk of errors and calcium creatinine ratio has been used as a marker of hypercalciuria. OBJECTIVES: determine the validity of this indicator as a hypercalciuria marker. METHODS: a cross-sectional descriptive study was conducted due to the importance of the diagnosis of hypercalciuria and disagreements on the utility of calcium creatinine ratio and optimal cutoff. 1603 Cuban lithiasic subjects were studied. Their age ranged between 2 and 19 years. 24 hour urinary calcium and calcium- creatinine ratio of the second morning urine were studied. RESULTS: moderate positive correlation between variables was obtained. For values of traditional cutting of calcium creatinine ratio, sensitivity was 95.7% and 81.9%, and specificity 48.3% and 66.7% for children and adolescents, respectively. CONCLUSIONS: calcium creatinine ratio is useful as evidence of population screening for hypercalciuria, however for diagnostic confirmation the measurement of urinary calcium is inevitably required by collecting urine for 24 hours.