الفهرس 
Renal effects of preeclampsiaOnly 14 pages are availabe for public view
 |  | from | 134 |  |  |
| | | from | 134 | | |
Abstract
Preeclampsia is a complex and serious multi-system disorder of pregnancy with a worldwide incidence of 5-7% and contributes significantly to maternal and perinatal morbidity and mortality. It is characterized by hypertension, proteinuria, and a generalized systemic vasoconstriction resulting from circulatory disturbances secondary to a generalized endothelial dysfunction caused by inflammation. It is associated with defective trophoblastic invasion and insufficient remodeling of the uterine spiral arteries.
Altered renal function is an essential component of the pathophysiological process in PE, so close monitoring of renal function is important to ensure a timely delivery before serious renal damage occurs.
Serum cystatin C is an endogenous marker of renal function. It is synthesized by all nucleated cells, produced at a constant rate and is exclusively eliminated by glomerular filtration. Several studies have shown that serum cysC is a better marker for glomerular filtration rate than serum creatinine particularly for individuals with small to moderate decrease in GFR.
The aim of this study is to evaluate diagnostic value of Cystatin C serum levels as an alternative marker of renal function in women with severe preeclamptic toxemia versus matching cases of normal pregnancy and compare it with the traditional markers of renal function, Creatinine, urea and serum uric acid.
This study was conducted at the department of Obstetrics and Gynecology, at Tanta university hospital from April 2016 to April 2017 on 80 Primigravidae with singleton pregnancy, absence of concomitant disease and gestation ≥28 weeks and were divided into two groups, group 1: (40 patients) with severe preeclampsia. group 2: (40 patients) as control group normotensive and nonproteinuric. Markers of kidney function were investigated in two groups of pregnant women and comparison between both groups as regards to cysC serum levels, creatinine, blood urea and serum uric acid was done.
The results of this study showed that levels of traditional renal parameters (SCr, blood urea and serum uric acid) were found to be higher in study group compared to control group. The difference in the mean serum uric acid level (5.10 ± 0.96 versus 4.70 ± 0.63 mg/dl) was significantly higher in the preeclampsia (p = 0.027), the specificity was 100% and sensitivity of the test was 87.5%, the difference in the mean serum concentration of creatinine (0.94 ± 0.16 versus 0.86 ± 0.12 mg/dl) was significantly higher in preeclampsia (p = 0.028), the specificity of the test was 100% and the sensitivity was 82.5%. Serum cystatin C level has a mean (1.26 ± 0.21 versus 0.75 ± 0.05 mg/l) which was significantly higher in preeclampsia (p = 0.001) with a specificity 100% and sensitivity 96%.
Hence our study was undertaken to find out the use of Serum cysC as early and better marker of renal function in PE. Serum cysC was found to be superior to other renal function markers in PE and it can be used as predictor of PE and some work should be done on alterations of serum cysC in PE.