The relation between urine Calcium-creatinine ratio

and severe preeclampsia

Introduction
Preeclampsia is still the leading cause of maternal morbidity and mortality around the
world. Preeclampsia is a wide vascular endothelial damage and vasospasm disease
which occur after the 20th week of gestational and may be last until four to six week
after delivery.
This condition frequently ends up with morbidity and mortality to both the
mother and the child. A marker to predict the risk of developing preeclampsia is crucial
for it is early diagnostic, prevention, therapy and follow up. With the early detection,
hopefully initial intervention could be done to prevent more dangerous event to the
mother and fetus.
Decreasing calcium excretion and urine creatinine level can be used as tool to
diagnose early development of severe preeclampsia. When used as a single modality,
calcium per creatinine ratio can predict severe preeclampsia better then urine
microalbumin concentration. It can predict severe preeclampsia with a simpler, non-
invasive procedures and a less cost.

Objective
To find the relation between urine calcium-creatinine ratio and severe
preeclampsia

Methods
This research used a prospective cross sectional method with 60 sample divided
into two groups, 30 patients in pregnant women with severe preeclampsia group and
the other 30 in the women with normotensive. Sample had been taken in the RSUP Prof
R. D. Kandou and Sam Ratulangi University, medical faculty, obstetric and gynecology
department satellite hospital which fulfilled inclusion and exclusion criteria. Patients
who had been explained and signed agreement to participate in this research then
collect their urine in 24 hours and sent it to the laboratory to examine it calcium and
creatinine concentration. After the data gathered, statistical analysis was performed
using SPSS ver. 22.0.

Results
Most respondent in either severe preeclampsia group or normotensive group were in
their 37 week of gestation or more, that is 19 women (63,3%) and 22 women (73,34%)
respectively. Women in the severe preeclampsia group mostly aged 25-29 years old, ie
11 women (36,67%) while the normotensive group mostly aged 20-24 years old, ie 9
women (30%). By it is parity, both groups were dominantly multigravida, 16 persons
(53,33%) in the severe preeclampsia group and 19 (63,33%) in normotensive group
Average urine calcium excretion in severe preeclampsia group are 59,950 ±
54,405 mg/dl with range 3,2-201 mg/dl, fewer compared to normotensive group calcium
excretion which is averaging 138,56 ± 155,18 mg/dl with range 10,4-515,8 mg/dl. Urine
creatinine level In severe preeclampsia group are lower than the normotensive group, ie
420,87 ± 193,950 mg/dl and range 74-873 mg/dl compared to 732,03 ± 445,768 mg/dl
with range 58-1882 mg/dl. Urine calcium-creatinine ratio in severe preeclampsia group
are 0,1667 ± 0,1553 with range 0,01-0,56 while in the normotensive group are 0,2603 ±
0,3656 with range 0,01 – 1,92
Conclusion
From this research can be concluded that in patients with severe preeclampsia
there is a low rate of calcium and creatinine excretion. The analytical result for relation
between urine calcium-creatinine ratio and severe preeclampsia is the lower the urine
calcium-creatinine ratio in pregnant women, the higher the risk of developing severe
preeclampsia.

Keywords: severe preeclampsia, urine calcium-creatinine ratio