High first-trimester maternal blood cystatin C levels despite normal serum creatinine predict pre-eclampsia in singleton pregnancies.

Risch, Martin; Purde, Mette-Triin; Baumann, Marc Ulrich; Mohaupt, Markus; Mosimann, Beatrice; Renz, Harald; Raio, Luigi; Surbek, Daniel; Risch, Lorenz (2017). High first-trimester maternal blood cystatin C levels despite normal serum creatinine predict pre-eclampsia in singleton pregnancies. Scandinavian journal of clinical and laboratory investigation, 77(8), pp. 634-643. Taylor & Francis 10.1080/00365513.2017.1393692

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Early biochemical identification of women at high risk for the development of pre-eclampsia (PE) is still unsatisfactory. Renal markers measured during the first trimester were analysed to predict later occurrence of PE. A nested case-control study was conducted within the prospective predictive markers for the diagnosis of preeclampsia study. Pregnant women were included at the end of the first trimester and followed up until birth. Controls were matched to PE cases. Renal markers [i.e. creatinine, cystatin C (CysC), β2 microglobulin (B2M), β-trace protein (BTP), glomerular filtration rate estimations (eGFR) of the aforementioned markers, uric acid (UA), urea, and serum uromodulin (sUMOD)] were compared to placental growth factor (PlGF), a marker known to predict PE later in pregnancy. Reference intervals were determined for the different markers. In the 183 women (PE, n = 39; controls, n = 144), CysC, the CysC/PlGF ratio (p < .01) and UA were higher, whereas the eGFRCysC/eGFRCrea ratio (a marker of glomerular endothelial integrity and shrunken pore syndrome) and PlGF were lower in women who developed PE (p < .05 for all). Compromised filtration of the larger molecule CysC together with a normal creatinine, in a subset of PE cases (15.3%) was a unique, strong and independent predictor of later PE if the baseline CysC concentration was >0.85 mg/l. In conclusion, CysC and its derivatives as well as UA, indicating volume expansion, measured at the end of the first trimester are predictive of PE. Thus, women can be easily identified and followed as an early reduction in glomerular filtration quality poses a high risk for a subsequent development of PE.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Gynaecology
04 Faculty of Medicine > Department of Haematology, Oncology, Infectious Diseases, Laboratory Medicine and Hospital Pharmacy (DOLS) > Institute of Clinical Chemistry
04 Faculty of Medicine > Other Institutions > Teaching Staff, Faculty of Medicine

UniBE Contributor:

Baumann, Marc Ulrich; Mosimann, Beatrice; Raio, Luigi; Surbek, Daniel and Risch, Lorenz

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0036-5513

Publisher:

Taylor & Francis

Language:

English

Submitter:

Monika Zehr

Date Deposited:

20 Mar 2018 12:12

Last Modified:

20 Mar 2018 12:12

Publisher DOI:

10.1080/00365513.2017.1393692

PubMed ID:

29069989

Uncontrolled Keywords:

Beta-trace protein beta-2-microglobulin creatinine cystatin C glomerular filtration rate placental growth factor pre-eclampsia reference intervals uric acid uromodulin

URI:

https://boris.unibe.ch/id/eprint/110879

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