ABSTRACT
Purpose: Pregnancy?induced hypertension is a multisystem disorder that occurs after 20 weeks of pregnancy usually in primigravidas and is characterised by proteinuria, pedal edema, hypertension, and abnormal liver and kidney function tests. Since there exists a close relationship between retinal, cerebral, and renal vessels, fundoscopy gives the opportunity of observing the changes in the vascular tree. Methods: We conducted a study on 203 pregnant females over a period of 1.5 years in the rural population of North India. We recorded the baseline data from the patient files, including the biochemical investigations, and conducted a fundoscopic examination of all patients included in the study, and correlation of various variables was established. Results: Out of 203 patients (403 eyes), 60% were primigravidas of mean age 25.71 ± 4.46 years with the mean duration of pregnancy being 36 weeks. The mean systolic and diastolic blood pressure were160 and 101 mmHg, respectively. There was no significant correlation was seen of proteinuria with eclampsia and the fundus findings. But there was a significant correlation between proteinuria and pedal edema and between the fundus findings and deranged LFT and KFT values. Relationship between the variables was calculated by using Chi?square and Fisher’s exact test. A P value < 0.05 was taken as significant. Conclusion: Hypertension in pregnancy is the major concern of public health issue worldwide. With proper understanding of the correlating factors such as fundus changes which are directly correlated with whole bo dy vascular changes, which might affect the fetal growth, we can easily predict the outcome and can take appropriate actions as early as possible
ABSTRACT
Objective: To Compare performance of combined creatinine and cystatin C-based equation with equations based on either cystatin C or creatinine alone, in early chronic kidney disease. Design: Diagnostic accuracy study. Setting: Tertiary-care hospital. Patients: One hundred children with chronic kidney disease who underwent 99mTc diethylenetriamine pentaacetic acid (DTPA) glomerular filtration rate measurement. Methods: Estimating equations for glomerular filtration rate (GFR) based on serum cystatin C alone and in combination with serum creatinine were generated using regression analyses. These equations and the creatinine-based equation [0.42 x height/creatinine] were validated in 42 children with glomerular filteration rate between 60 and 90 mL/min/1.73 m2. Bias, precision and accuracy of estimating equations using DTPA glomerular filteration rate as gold standard. Results: Cystatin C-based equation (GFR=96.9 - 30.4 x cystatin) overestimated while the combined cystatin C-and creatininebased equation [GFR=11.45 x (height/creatinine) 0.356 x (1/ cystatin) 0.188] underestimated the measured GFR. Cystatin Cbased equation had less bias (1.9 vs. 12.4 ml/min/1.73 m2), and higher precision (13.1 vs. 25.6 mL/min/1.73 m2) and accuracy (92.1% vs. 75.7%) than creatinine-based equation. The combined cystatin C and creatinine equation had bias (-1.4 mL/ min/1.73 m2) precision (15.2 mL/min/1.73 m2) and accuracy (91.2%) similar to cystatin C-based equation. Conclusions: Cystatin C-based equation has a better performance in estimating glomerular filtration rate than creatinine-based equation in children with early chronic kidney disease. Addition of creatinine equation does not improve the performance of the cystatin C-based equation.
ABSTRACT
d be used to evaluate the function of severely obstructive hydronephrotic kidneys with no image on IVU, which can reflect its objective function, especially one to two weeks after nephrostomy in hypertonic hydronephrostic kidneys, and is better than IVU.