Micro-Albuminuria in Random Daytime Specimens in Pregnancy Induced Hypertension

Summary

Micro-albuminuria as measured by the albumin/creatinine ratio may be a practical method to detect early renal involvement in hypertensive pregnancies. This ratio was measured in 162 patients; 27 developed proteinuric pregnancy induced hypertension, 72 remained nonproteinuric pregnancy hypertensives and 63 were normotensive throughout. The three clinical categories could be separated prospectively on the basis of their albumin/ creatinine ratios (P < 0.00001) although there was some overlap. Twenty-nine per cent of patients with nonproteinuric and 89 per cent of patients with proteinuric pregnancy induced hypertension had an albumin/ creatinine ratio of greater than 3.5 mg/mmol but 95 per cent of women with normotensive pregnancies had an albumin/creatinine ratios of less than this. The ratio did not predict low birth weight or intra-uterine growth retardation in hypertensive patients. No correlation was found between urate and albumin/creatinine ratio and no relationship with platelet count and liver function tests. There is a spectrum of disease activity in pregnancy induced hypertension ranging from absence of microalbuminuria to gross proteinuria.