Pre-Eclampsia: Epidemiology and Renal Biomarkers at Brazzaville University Hospital

Introduction: Renal function exhibits physiological changes during the gestational period such as increased renal blood flow and glomerular filtration. These effect certain renal biomarkers whose normal and abnormal nature is necessary to be apprehended. Aim: To analyse the epidemiological characteristics and renal biomarkers during Pre-Eclampsia (PE) at the Brazzaville University Hospital. Materials and Methods: A case-control study was conducted at the Brazzaville University Hospital from 1 June to 30 November 2018, comparing PE and non-hypertensive gestates according to the ratio of one case for two controls. Assays for renal biomarkers were performed spectrophotometrically and potentiometrically. The variables studied were epidemiological, clinical, and renal biomarkers including creatinine, creatinine clearance, uraemia, serum uric acid, 24-hour creatinine, 24 hour proteinuria, sodium, chloride, and potassium, The tests of t-student and Mann Whitney were used respectively for the comparison of means and medians. The p-value of the probability was considered significant for a value less than 5%. A multivariate analysis was performed to eliminate confusion bias. Results: PE were not different from controls with respect to median age (31.5 years (23-39.5) vs. 28 years (23.5-32), p>0.05); parity (1.5 (1.5-2.5) vs. 1.5 (1.5-2), p>0.05) and the term of pregnancy (32.2 +/- 2.86A vu 32.1 +/- 2.7SA, p>0.05). Diuresis was lower in the cases (852.5 mL vs. 1365 mL, p<0.05). In bivariate analysis, renal markers associated with pre-eclampsia were serum creatinine (81.5 mu mol/L vs. 56.5 mu mol/L, p<0.05), creatinine clearance (91.8 mu L/min vs. 140, 1 mL/min, p<0.05), serum uric acid (408 mu mol/L vs. 250.5 pmol/L, p<0.05), and hypocreatinuria (p<0.05). The concentrations of azotaemia and electrolytes were not different from those of the controls. After logistic regression, the renal biomarkers retained were hypocreatinuria (p<0.05) and hyperuricaemia (p<0.05). Renal biomarkers were not influenced by age, parity, and the term of pregnancy (p<0.05). Conclusion: Although having identical epidemiological characteristics, creatinuria and serum uraemia are significantly disturbed in pre-eclamptic patients. A subsequent multi-center study integrating multi-organ recall would clarify their prognostic value as well as the biological profile of PE in Brazzaville.