Monitoring renal function in hypertensive pregnancy

Hypertension in Pregnancy : Official Journal of the International Society for the Study of Hypertension in Pregnancy
Anne-Marie CôtéLaura A Magee

Abstract

In hypertensive pregnancy, to compare 24hr creatinine clearance (CrCl) with formulae-derived renal function (Cockcroft-Gault (CG) or Modified Diet in Renal Disease (MDRD)). Retrospective review (198 women, 63% preeclampsia) using paired t-test (significant p < 0.008) and intraclass correlation coefficients (acceptable >0.70) to compare 24hr and CG CrCl. The 24hr CrCl was compared with each of the CG and MDRD formulae by Bland-Altman plots. For 24hr CrCl, uncorrected values were similar to corrected using pre-pregnancy weight (p = 0.04); other weights gave consistently different CrCl (p < 0.0001). Limits of agreement were wide when CG and MDRD formulae were compared with 24hr CrCl. Compared with 24hr CrCl, MDRD estimates were consistently lower, and CG CrCl higher (current weight) or lower (pre-pregnancy or lean weight). MDRD and CG formulae should not be used in hypertensive pregnancy. Use of serum creatinine is advocated. If 24hr CrCl is performed, any correction should utilize pre-pregnancy weight. Neither the Cockcroft-Gault nor Modified Diet in Renal Disease formulae for glomerular filtration rate estimation are alternatives to 24hr creatinine clearance in hypertensive pregnancy.

References

Jan 1, 1976·Nephron·D W Cockcroft, M H Gault
Nov 1, 1992·British Journal of Obstetrics and Gynaecology·S W Lindow, D A Davey
Nov 1, 1985·Kidney International·O ShemeshB D Myers
Jun 16, 1995·The Science of the Total Environment·B Armstrong
Sep 1, 1993·American Journal of Obstetrics and Gynecology·J F HuddlestonC E Flowers
Apr 15, 2000·Journal of Molecular Biology·K R LiebermanH F Noller
May 10, 2000·Clinical Pharmacokinetics·J F Lu, C H Nightingale
Oct 20, 2001·American Journal of Obstetrics and Gynecology·A M AdelbergD S Lambers
Apr 22, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Ayub AkbariGuido Filler
Aug 16, 2006·Annals of Internal Medicine·Andrew S LeveyUNKNOWN Chronic Kidney Disease Epidemiology Collaboration
Oct 3, 2007·American Journal of Perinatology·Arnold B AlperJules Puschett
Nov 1, 2007·BJOG : an International Journal of Obstetrics and Gynaecology·M C SmithJ M Davison
Nov 21, 2007·The British Journal of Dermatology·C E H GrattanUNKNOWN British Association of Dermatologists Therapy Guidelines and Audit Subcommittee
Aug 23, 2008·American Journal of Obstetrics and Gynecology·Anne-Marie CôtéLaura A Magee

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Citations

Jan 27, 2011·Seminars in Nephrology·Tom CornelisMichelle Hladunewich
Jan 23, 2018·Clinical Pharmacokinetics·Laura A Hart, Gail D Anderson
Apr 10, 2017·Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association·Michelle A HladunewichSharon Maynard
May 12, 2017·Obstetric Medicine·Peter von Dadelszen, Laura A Magee
Dec 1, 2012·Obstetric Medicine·Tiina Podymow, Phyllis August
Feb 18, 2017·Kidney International·Philip WebsterMichelle A Josephson
Jul 13, 2021·Taiwanese Journal of Obstetrics & Gynecology·Aysun Tekeli Taşkömür, Özlem Erten

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