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. 2013;131(2):106-11.
doi: 10.1590/s1516-31802013000100021.

Natriuria and calciuria levels in preeclampsia: a cross-sectional study

Rose Gasnier  1 , Edimárlei Gonsales Valério, Janete Vettorazzi, Sérgio Hoffmeister Martins-Costa, Elvino Guardão Barros, José Geraldo Lopes Ramos
Affiliations

Natriuria and calciuria levels in preeclampsia: a cross-sectional study

Rose Gasnier et al. Sao Paulo Med J. 2013.

Abstract
in English, Portuguese

Context and objective: Sodium excretion abnormalities in preeclampsia have been studied in relation to several factors. The objective of this study was to compare natriuria (mEq/24 h) and calciuria levels (mg/24 h) in preeclamptic patients.

Design and setting: An analytical cross-sectional study with a control group was conducted in the obstetric center and the high-risk pregnancy outpatient clinic at a university hospital in southern Brazil, and in a primary healthcare unit in the same city, including pregnant women with mild preeclampsia, severe preeclampsia or chronic hypertension, and women with normal pregnancies (14 patients in each group).

Method: Natriuria was measured using an ion-selective electrode in an automated clinical chemistry analyzer (Hitache 917, Roche). All the patients collected 24-hour urine, at home or at the hospital, for analysis of proteins, creatinine, calcium, sodium and uric acid. Quantitative variables with asymmetrical distribution were described using the median, minimum and maximum, and were compared using the Kruskal-Wallis test. The results were logarithmically transformed, with one-way analysis of variance (ANOVA) by ranks and then the post-hoc Tukey test, and were analyzed by means of the Spearman correlation and receiver operating characteristic (ROC) curve. The significance level used was 0.05.

Results: There were significant differences between the groups in comparing severe preeclampsia with chronic hypertension and severe preeclampsia with controls (P < 0.0001 for both measurements).

Conclusion: Natriuria levels may be lower in preeclampsia when associated with calciuria. Natriuria assessment is an additional test for differential diagnosis of hypertensive diseases in pregnancy, but is a poor predictor when used alone.

CONTEXTO E OBJETIVO:: Alterações na excreção de sódio têm sido estudadas na pré-eclâmpsia relacionadas a vários fatores. O objetivo deste estudo foi comparar natriúria (mEq/24 h) com os níveis de calciúria (mg/24 h) em pacientes pré-eclâmpticas.

ESTUDO E LOCAL:: Estudo transversal analítico com grupo controle foi realizado no Centro Obstétrico e no Ambulatório de Gestação de Alto Risco em um hospital universitário no sul do Brasil, e na Unidade Básica de Saúde na mesma cidade, incluindo gestantes com pré-eclâmpsia leve e grave, hipertensão crônica e gestações normais, com 14 pacientes em cada grupo.

MÉTODO:: A natriuria foi dosada através da medida de íon eletrodo seletivo, utilizando analizadores automáticos de química clínica (Hitache 917 Roche). Todas as pacientes coletaram urina de 24 h, em casa ou no hospital, para análise de proteínas, creatinina, cálcio, ácido úrico e sódio. As variáveis quantitativas com distribuição assimétrica foram descritas por mediana, mínimo e máximo, e comparadas por teste Kruskal-Wallis. Os resultados foram transformados logaritmicamente, com ANOVA one-way por ranking e, posteriormente, teste post-hoc de Tukey, e foram analisados por médias de correlações de Spearman e curva ROC (receiver operating characteristic). O nível de significância adotado foi de 0.05.

RESULTADOS:: Foram encontradas diferenças significativas entre os grupos quando comparados pré-eclâmpsia grave com hipertensão crônica e pré-eclâmpsia grave com controles (P < 0.0001 para ambas as medidas).

CONCLUSÃO:: Natriúria pode estar reduzida na pré-eclâmpsia quando associada com calciúria. Avaliação da natriúria é um teste adicional para diagnóstico diferencial de doenças hipertensivas na gestação, mas é um pobre preditor quando utilizado isolado.

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Conflict of interest statement

Conflict of interest: None

Figures

Figure 1.
Figure 1.. Proteinuria and natriuria correlation.
Figure 2.
Figure 2.. Calciuria and natriuria correlation.
Figure 3.
Figure 3.. Natriuria and preeclampsia diagnosis.
See this image and copyright information in PMC

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