Resumen de Importancia del ácido úrico, la creatinina y al excreción urinaria de proteinas como marcadores de riesgo en diabéticas e hipertensas gestacionales

Paloma Segovia, Antonio Cruceyra, María J. L. Álvarez, Eloy Asenjo, José A. Clavero, María Cristina Fernández Pérez

• Objective: The hypothesis that renal function tests show similar changes in GDM and gestational hypertension was evaluated. Study design: We made a nested case-control study to determine if the serum concentrations and respective clearances of serum uric acid and creatinine show similar changes in 150 patients with GDM, 44 patients with gestational hypertension and 122 controls. Results: Mean serum uric acid values were higher in patients with GDM and in patients with gestational hypertension than in controls (P <0,001). Compared with controls, serum creatinine concentration increased and creatinine clearance decreased in the GDM group (P≤0,01) and uric acid clearance fell and urinary protein concentration increased in gestational hypertensive group (P≤0,02). When clearances were adjusted for fasting glucose level and diastolic blood pressure, uric acid clearance was a significant independent predictor of gestational hypertension and creatinine clearance was a significant predictor of GDM. Hyperuricemia was associated with maternal blood pressure (P≤0,01). Only a moderate correlation was found between serum uric acid and urinary protein concentration in the gestational hypertension group (r = 0,50, P = 0,01). Conclusions: Although both disorders may have a common etiopathogenesis, the findings in women with gestational hypertension may be related with changes in renal tubular function similar to those described for insulin resistance, but in women with GDM only glomerular filtration raate (GFR) appeared to be affected. The predictive value of these renal function disorders needs to be evaluated.