Diagnostic Value of Urinary Microalbumin Level in Postpartum Acute Kidney Injury
AbstractBackground: We aimed to explore the diagnostic value of urinary microalbumin (mALB) level in postpartum acute kidney injury.Methods: A total of 127 maternity patients were selected from December 2013 to January in 2016 in Binzhou Central Hospital, Binzhou, Shandong, China and divided into two groups: the kidney injury and normal kidney group. The dynamic changes and diagnostic value of urine microprotein in postpartum acute kidney injury were analyzed.Results: The postpartum mean arterial pressure of maternity patients in the kidney injury group was 104.3 ± 11.6 mmHg, which was significantly higher than that of the normal kidney group (P<0.05). The mean age of the kidney injury group was 32.3 ± 11.6 years, which was significantly higher than that of the normal kidney group (P=0.006). In the kidney injury group, the postpartum glomerular filtration rate (GFR) was 78.4 ± 11.5 mL/min, which was significantly lower than the normal group (P=0.001), and urinary microalbumin was 2.87 ± 1.24 mg/mmol·Cr. The difference was statistically significant (P=0.002). mALB/GFR, Cr, urinary mALB, and GFR were the independent risk factors of postpartum acute kidney injury. The area under the ROC curve for mALB/GFR was 0.759, whereas the area under the ROC curve for Cr was 0.681, which was smaller (P = 0.042). The area under the ROC curve of mALB was 0.785 (P=0.027), which was close to the area under the ROC curve of mALB/GFR.Conclusion: Urinary mALB test is noninvasive and has high diagnostic value for postpartum kidney injury.
Eswarappa M, Madhyastha PR, Puri S, Varma V, Bhandari A, Chennabassappa G (2016). Postpartum acute kidney injury: a review of 99 cases. Ren Fail, 38: 889-893.
Frimat M, Decambron M, Lebas C et al (2016). Renal Cortical Necrosis in Postpartum Hemorrhage: A Case Series. Am J Kidney Dis, 68: 50-57.
Pahwa N, Bharani R, Kumar R (2014). Post-partum acute kidney injury. Saudi J Kidney Dis Transpl, 25: 1244-1247.
Hussein W, Lafayette RA (2014). Renal function in normal and disordered pregnancy. Curr Opin Nephrol Hypertens, 23: 46-53.
Gude D, Chennamsetty S, Jha R, Bopparaju SR (2013). APLA in post-partum renal cortical necrosis another skeleton in the closet. Saudi J Kidney Dis Transpl, 24: 141-143.
Xue HY, Yuan L, Cao YJ, Fan YP, Chen XL, Huang XZ (2016). Resveratrol ameliorates renal injury in spontaneously hypertensive rats by inhibiting renal micro inflammation. Biosci Rep, 36: e00339.
Kin Tekce B, Tekce H, Aktas G, Sit M (2014). Evaluation of the urinary kidney injury molecule-1 levels in patients with diabetic nephropathy. Clin Invest Med, 37: E377-383.
Li F, Guijt RM, Breadmore MC (2016). Na-noporous Membranes for Microfluidic Concentration Prior to Electrophoretic Separation of Proteins in Urine. Anal Chem, 88: 8257-63.
Diop MM, Diao B, Toure PS, Leye MY, Tall A, Ka MM (2012). Acute renal failure in the postpartum due to calcified myoma: a case report. West Afr J Med, 31: 20420-6.
Xu LP, Liu H, Wang SB, Chen X, Zheng XQ (2006). Early diagnosis value of uromicroprotein on renal injuries during pregnancy. Chin J Obs/Gyne & Pediatr (Electronic Version), 2: 30-31.
Qiao P, Zeng HS, Huang F, He XW (2015). Relationship between micoalbuminuria to estimated glomerular filtration rate ratio and incident of contrast induced nephropathy. Chin J Pract Med, 31: 1790-1793.
Hamouda M, Skhiri H, Toumi S, Aloui S, Ahmed L, Ben Dhia N, Frih A, Zakhama A, Elmay M (2013). Post-infectious glomerulonephritis: unusual etiology of postpartum acute renal failure. Nephrol Ther, 9: 228-230 [In French].
Song G, Li Y, Li M, Xuan R (2012). Acute renal and liver failure due to acute fatty liver of pregnancy-complicated pre-eclampsia. J Obstet Gynaecol, 32: 702-703.
Abudiab M, Krause ML, Fidler ME, Nath KA, Norby SM (2013). Differentiating scleroderma renal crisis from other causes of thrombotic microangiopathy in a postpartum patient. Clin Nephrol, 80: 293-297.