STUDY OF URINARY CALCIUM AND URINARY CREATININE LEVELS AND URINARY CALCIUM/CREATININE RATIO IN GESTATIONAL HYPERTENSIVE PATIENTS

BACKGROUND: Gestational hypertension (BP>140/90mmHg) or pregnancy induced hypertension usually precedes pre-eclampsia (BP>140/90mmHg associated with proteniuria). Many tests to predict pre-eclampsia are coming up on the horizon. Hypocalciuria is one such test to predict pre-eclampsia which may be present before other clinical signs and symptoms. AIM: To determine urinary calcium, urinary creatinine and urinary calcium/creatinine ratio in pregnancy induced hypertension and in normal pregnant women. MATERIAL AND METHODS: The study included 100 subjects with gestational age between 24-38 weeks and divided into two groups' viz. control group and study group. The control group included 50 subjects who were normal pregnant women and study group included 50 subjects who were gestational hypertensive patients. Urinary calcium was estimated by Ortho-Cresolphthalein Complexone (CPC) method, urinary creatinine was estimated by Jaffe's method in all the subjects. RESULTS: The estimated mean levels (Mean +/- SD) of urinary calcium, creatinine in control group were 263.0 +/- 80.3, 0.95 +/- 0.16 respectively and in patients with gestational hypertension they were 86.2 +/- 19.5, 1.21 +/- 0.37 respectively. The statistical analysis by unpaired t-test shows that the levels of urinary calcium were significantly decreased (p<0.001) and the urinary creatinine were significantly increased (p<0.001) in gestational hypertensive patients when compared to healthy controls. The mean urinary calcium/creatinine ratio in control group were 0.28 +/- 0.08 and in gestational hypertensive patients were 0.07 +/- 0.03. The statistical analysis by unpaired t-test shows that the levels of urinary calcium/creatinine ratio were significantly decreased (p<0.001) in gestational hypertensive patients when compared to healthy controls. CONCLUSION: This study suggests that a regular evaluation of urinary calcium/creatinine ratio after 20wks of gestation may be an effective screening method for impending pre-eclampsia and may identify population at risk to be included in primary prevention programmes.