الفهرس | Only 14 pages are availabe for public view |
Abstract Summary his observational cross-sectional study was carried out at Ain Shams University Maternity Hospital during the period from September 2012 till December 2013. Our study aims at assessing the reliability of random urine sample (urine Albumin /Creatinine ratio and urine Protein/Creatinine ratio) as a screening method for assessment of Micro-albuminuria and proteinuria in diabetic pregnant women. The current study included pregnant women with pregestational diabetes mellitus either type 1 or type 2 diabetes mellitus. Women with chronic renal disease, autoimmune disease, multiple gestation, gestational diabetes mellitus, preeclampsia and current or recent urinary tract infection were excluded. The 24 hour urine sample was collected for protein and microalbumin estimation. A random urine sample was taken for checking (microalbumin, protein and creatinine) levels and the urinary albumin/creatinine ratio, urinary protein/ creatinine ratio was calculated. Blood sample was taken for measuring blood urea nitrogen and serum creatinine for excluding renal impairment and measuring HbA1C to detect the glycemic state of the patient. A total 100 pregnant women were included. All included women had pregestational diabetes mellitus with age ranged from 18 years to 35 years with mean ±SD 30.2±4years and gestational age from6 weeks to 36weeks with mean±SD26.8±9weeks. Of the T Summary 9 0 included 100 women, (56%) 56 women had no microalbuminuria, (38%)38 women had microalbuminuria,(6%) 6 women had macroalbuminuria (as regard reference range 30-300 mg/24 h),(94%) 94women had no proteinuria and (6%) 6 women had proteinuria (as regard reference value ≥ 300mg/24h). The mean total microalbuminuria was88.6 mg per 24 hours (±150, range: 7-3000). The mean total proteinuria78 mg/24 hour (±90, range: 2.6-705).The mean random urinary albumin/creatinine ratio was 82.6 mg/g (±120, range 6.3-2068). The mean random urinary protein/creatinine ratio was 0.26mg/g (±0.55, range0.01-5).The mean serum urea nitrogen 18.90(±4.92, range 11-23). The mean serum creatinine 0.6 (±0.22, range 0.3-1.1). The mean HbA1C 6.1 (±1.8 range 4.3 – 16). Our study showed a significant positive correlation between albumin/creatinine ratio in random urine sample and each of 24-hour microalbuminuria (r=0.85, p<0.05) and 24-hour proteinuria (r=0.20, p<0.05). There was a significant positive correlation between 24-hour proteinuria and random urinary protein/creatinine ratio (r=0.45, p<0.05). There was a significant positive correlation between albumin/creatinine ratio in random urine sample and glycosylated hemoglobin (r=0.29, p=0.04). There was no correlation between albumin/ creatinine ratio in random urine sample each of age (p=0.08), weight (p=0.3), BMI (P=0.085), parity (p=0.075).There was no correlation between protein / creatinine ratio in random urine sample and each of age (p=0.07), weight (p0.1), BMI (P=0.15), parity (p=0.065). |