Clinical utility of serum creatinine, uric acid and eGFR in hypertensive disorders of pregnancy

Background: Hypertensive disorders of pregnancy (HDPs), a major complication during pregnancy, affect serum creatinine, uric acid levels, as well as estimated glomerular filtration rate (eGFR). However evidence supporting these associations in the Sri Lankan context remains limited. Therefore the present study investigated these renal parameters in HDPs, in a selected Sri Lankan pregnant population.Method: A case-control study was conducted at a tertiary care hospital in 31 normotensive and 31 gestational hypertensive pregnant women, all in their third trimester singleton pregnancy. Serum creatinine and uric acid levels were measured using a kinetic enzymatic colorimetric method and eGFR levels were calculated using the CKD-EPI equation. Pooled t-test, Spearman correlation test and Receiver Operating Characteristic (ROC) curves were the statistical tests performed using SPSS software. p<0.05 was deemed significant.Results: The mean serum creatinine between normotensive and gestational hypertensive pregnant women was significantly different (0.55±0.06 mg/dL vs. 0.60±0.09 mg/dL; p=0.037). The mean serum uric acid levels were not statistically significant. There was a significant difference in the mean eGFR between the cases and controls (127.42±4.98 ml/min/1.73m2 vs. 122.26±8.07 ml/min/1.73m2; p=0.004), respectively. The ROC curves did not show a significant Area Under the Curve (AUC) for serum creatinine and uric acid in HDP [AUC=0.66 and 0.52, respectively]. However, eGFR showed a significant performance in differentiating HDP (AUC=0.72, p=0.003).Conclusion: Lower eGFR levels and higher serum creatinine levels are associated with gestational hypertensive pregnancies compared to normotensive pregnancies. eGFR levels are more reliable, aiding early detection of renal impairment and potentially reducing chronic kidney disease (CKD) risks in hypertensive pregnant women.