Kidney Function in Normotensive and Preeclamptic Pregnancies: A Comparative Cross-Sectional Study in Abeokuta, Nigeria
DOI:
https://doi.org/10.71637/tnhj.v25i2.1091Keywords:
Preeclampsia, kidney dysfunction, serum creatinine, cystatin C, estimated glomerular filtration rate (eGFR), Federal Medical Centre, Abeokuta, Adrenal tumorAbstract
Background: Preeclampsia is a significant obstetric complication in Nigeria, associated with acute and long-term renal outcomes. This study compared renal function parameters in normotensive and preeclamptic pregnancies attending the antenatal clinic of the federal medical centre (FMC), Abeokuta, Nigeria.
Method: This was a comparative cross-sectional study involving 180 pregnant women (90 with preeclampsia and 90 normotensive controls) attending the antenatal clinic at FMC. Serum creatinine, cystatin C, uric acid, phosphate, calcium, and FBS were measured using standard automated spectrophotometry. Cystatin C was measured using a particle-enhanced nephelometric immunoassay. eGFR was calculated using the CKD-EPI equation and staged according to the KDOQI guideline. Statistical analysis was performed using SPSS version 25.0. Student’s t-test, Chi-square test, and Fisher’s exact test were used as appropriate, with p < 0.05 considered statistically significant.
Results: The mean eGFR was significantly lower in preeclamptic (p = 0.011). Serum cystatin C was significantly higher in the preeclamptic group (1.09 ± 0.62 mg/L vs. 0.80 ± 0.22 mg/L; p < 0.001). Kidney dysfunction (eGFR ≤ 60 mL/min) was identified in 11.1% of preeclamptic participants, and none in the control group (p < 0.001). Generalized edema, leg swelling, etc were significantly associated with kidney dysfunction among preeclamptic women (p = 0.010, 0.029, and <0.001, respectively).
Conclusion: Preeclampsia significantly increases the risk of kidney dysfunction in pregnancy. Symptoms like headache, leg swelling, and generalized edema may serve as early indicators. Routine renal function screening using cystatin C may aid in early detection and better outcomes, especially in low-resource settings.
Downloads
References
1. Duley L. The global impact of pre-eclampsia and eclampsia. SeminPerinatol. 2009; 33(3):130–137.
2. Steegers EA, von Dadelszen P, Duvekot JJ, Pijnenborg R. Pre-eclampsia. Lancet. 2010; 376(9741):631–644.
3. World Health Organization. WHO recommendations for prevention and treatment of pre-eclampsia and eclampsia.2011. https://apps.who.int/iris/handle/10665/44703
4. Roberts JM, Gammill HS. Preeclampsia: recent insights. Hypertension. 2005; 46(6):1243–1249.
5. Hladunewich MA, Karumanchi SA, Lafayette RA. Pathophysiology of preeclampsia. Clin J Am Soc Nephrol. 2007; 2(3):543–549.
6. Karumanchi SA, Maynard SE. Still a decade of discovery in preeclampsia. Am J Kidney Dis. 2019; 74(6):751–753.
7. Cheung KL, Lafayette RA. Renal physiology of pregnancy. Adv Chronic Kidney Dis. 2013; 20(3):209–214.
8. Davison JM. The kidney in pregnancy: a review. J R Soc Med. 1983; 76(10):820–827.
9. Brown MA, Lindheimer MD, de Swiet M, Van Assche A, Moutquin JM. The classification and diagnosis of the hypertensive disorders of pregnancy. J Hypertens. 2001; 19(11):1149–1158.
10. Hladunewich MA. Acute kidney injury in pregnancy. Adv Chronic Kidney Dis. 2013; 20(3):215–222.
11. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 379(9811):165–180.
12. Stevens LA, Coresh J, Greene T, Levey AS. Assessing kidney function measured and estimated glomerular filtration rate. N Engl J Med. 2006; 354(23):2473–2483.
13. Odden MC, Tager IB, Gansevoort RT, et al. Cystatin C and kidney function in the elderly. Ann Intern Med. 2012; 157(3):143–151.
14. Dharnidharka VR, Kwon C, Stevens G. Serum cystatin C is superior to serum creatinine as a marker of kidney function: a meta-analysis. PediatrNephrol. 2002; 17(12):903–907.
15. Laterza OF, Price CP, Scott MG. Cystatin C: an improved estimator of glomerular filtration rate? Clin Chem. 2002; 48(5):699–707.
16. Peralta CA, Katz R, Sarnak MJ, et al. Cystatin C identifies chronic kidney disease patients at higher risk for complications. J Am Soc Nephrol. 2011; 22(1):147–155.
17. Strevens H, Wide-Swensson D, Grubb A, et al. Serum cystatin C for assessment of glomerular filtration rate in pregnant and nonpregnant women. Indications of altered filtration. Am J Obstet Gynecol. 2002; 186(3):508–514.
18. Wattanavaekin K, Wattanavaekin T, Attia J. Diagnostic accuracy of cystatin C in preeclampsia. Int J NephrolRenovasc Dis. 2018; 11:187–194.
19. Arikan DC, Ozer A, Arikan T, Coskun A, Kilinc M. Plasma cystatin-C and beta-2 microglobulin levels in severe preeclampsia. Eur J ObstetGynecolReprod Biol. 2010; 149 (2):147–149.
20. Vikse BE, Irgens LM, Leivestad T, Skjaerven R, Iversen BM. Preeclampsia and the risk of end-stage renal disease. N Engl J Med. 2008; 359 (8):800–809.
21. Ayoola OO, Olusanya BO. Diagnostic accuracy of cystatin C and serum creatinine for detecting kidney dysfunction in Nigerian women with preeclampsia. Niger J ClinPract. 2020; 23 (1):40–46.
22. Ike SO, Okoye OC. Kidney disease in Nigeria: a review of epidemiologic data from renal registries and population-based studies. Int J NephrolRenovasc Dis. 2015; 8:7–19.
23. Muli AM, Obimbo MM, Musoke RN. Maternal serum cystatin C as a marker of renal function in pregnancy complicated by preeclampsia. Afr Health Sci. 2021; 21(1):122–129.
24. Hsu CY, Bansal N. Measured GFR as a confirmatory test for estimated GFR. J Am Soc Nephrol. 2011; 22(12):2295–2303.
25. Garovic VD, August P. Preeclampsia and renal disease: emerging links. CurrOpinNephrolHypertens. 2016; 25(2):91–95.

Published
Issue
Section
License
Copyright (c) 2025 Olusola Adebisi, A. K. Bakare, A. T. Vaughan, A. E. Faponle, K. A. Ahmed, A. Odeyemi, O. O. Okunola

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
The Journal is owned, published and copyrighted by the Nigerian Medical Association, River state Branch. The copyright of papers published are vested in the journal and the publisher. In line with our open access policy and the Creative Commons Attribution License policy authors are allowed to share their work with an acknowledgement of the work's authorship and initial publication in this journal.
This is an open access journal which means that all content is freely available without charge to the user or his/her institution. Users are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles in this journal without asking prior permission from the publisher or the author.
The use of general descriptive names, trade names, trademarks, and so forth in this publication, even if not specifically identified, does not imply that these names are not protected by the relevant laws and regulations. While the advice and information in this journal are believed to be true and accurate on the date of its going to press, neither the authors, the editors, nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
TNHJ also supports open access archiving of articles published in the journal after three months of publication. Authors are permitted and encouraged to post their work online (e.g, in institutional repositories or on their website) within the stated period, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access). All requests for permission for open access archiving outside this period should be sent to the editor via email to editor@tnhjph.com.