Twenty-four-hour proteinuria and acute kidney injury in women with preeclampsia in Peru

Authors

  • Brenda Belén Gabriel-Huamanchumo Cesar Vallejo University image/svg+xml Author
    Competing Interests

    None

  • Vera Silvana Garamendi-Sacsara Cesar Vallejo University image/svg+xml Author
    Competing Interests

    None

DOI:

https://doi.org/10.64716/wnh9mb14

Keywords:

Pre-Eclampsia, Proteinuria, Acute Kidney Injury, Pregnancy, Retrospective Studies

Abstract

Background: Proteinuria and acute kidney injury describe different aspects of renal involvement in preeclampsia. Objective: To evaluate the association between 24-hour proteinuria and acute kidney injury (AKI) among women with preeclampsia at a referral hospital in Trujillo, Peru, during 2018–2024. Methods: A retrospective analytical record review included 127 women selected by simple random sampling. Proteinuria status and category, AKI diagnosis and stage, age group, and residence were extracted from clinical records. Frequencies and percentages summarized categorical variables. Associations were evaluated using two-sided Fisher exact, Fisher–Freeman–Halton exact, or Pearson chi-square tests, according to table dimensions and expected frequencies. Results: Proteinuria was documented in 48 women (37.8%): 35 had mild proteinuria, eight moderate proteinuria, and five nephrotic-range proteinuria. Three women (2.4%) had AKI, comprising two stage I cases and one stage III case. All three AKI cases occurred among women with proteinuria, corresponding to 6.3% of that group, compared with 0.0% among women without proteinuria; the association did not reach statistical significance (p = 0.052). Proteinuria was not significantly associated with age group (p = 0.573) or residence (p = 0.367); corresponding AKI comparisons were also nonsignificant (p = 1.000 and p = 0.470). Conclusions: Proteinuria was more frequent than AKI in this sample. The primary comparison did not establish a statistically significant association, and the small number of AKI events warrants cautious interpretation of the magnitude of the relationship.

Downloads

Download data is not yet available.

References

Magee LA, Nicolaides KH, von Dadelszen P. Preeclampsia. N Engl J Med. 2022;386(19):1817-1832. https://doi.org/10.1056/nejmra2109523 DOI: https://doi.org/10.1056/NEJMra2109523

Magee LA, Brown MA, Hall DR, Gupte S, Hennessy A, Karumanchi SA, et al. The 2021 International Society for the Study of Hypertension in Pregnancy classification, diagnosis & management recommendations for international practice. Pregnancy Hypertens. 2022;27:148-169. https://doi.org/10.1016/j.preghy.2021.09.008 DOI: https://doi.org/10.1016/j.preghy.2021.09.008

Yanque-Robles O, Becerra-Chauca N, Nieto-Gutiérrez W, Alegría Guerrero R, Uriarte-Morales M, Valencia-Vargas W, et al. Clinical practice guideline for the prevention and management of hypertensive disorders of pregnancy. Rev Colomb Obstet Ginecol. 2022;73(1):48-141. https://doi.org/10.18597/rcog.3810 DOI: https://doi.org/10.18597/rcog.3810

Scurt FG, Morgenroth R, Bose K, Mertens PR, Chatzikyrkou C. Pr-AKI: Acute Kidney Injury in Pregnancy - Etiology, Diagnostic Workup, Management. Geburtshilfe Frauenheilkd. 2022;82(3):297-316. https://doi.org/10.1055/a-1666-0483 DOI: https://doi.org/10.1055/a-1666-0483

Trakarnvanich T, Ngamvichchukorn T, Susantitaphong P. Incidence of acute kidney injury during pregnancy and its prognostic value for adverse clinical outcomes: A systematic review and meta-analysis. Medicine (Baltimore). 2022;101(30):e29563. https://doi.org/10.1097/md.0000000000029563 DOI: https://doi.org/10.1097/MD.0000000000029563

Lu W, Hu MJ, Zhu DD, Lin FJ, Huang HD. Clinical characteristics and prognosis of pregnancy-related acute kidney injury: a case series study. Int Urol Nephrol. 2023;55(9):2249-2255. https://doi.org/10.1007/s11255-023-03484-6 DOI: https://doi.org/10.1007/s11255-023-03484-6

Fishel Bartal M, Lindheimer MD, Sibai BM. Proteinuria during pregnancy: definition, pathophysiology, methodology, and clinical significance. Am J Obstet Gynecol. 2022;226(2S):S819-S834. https://doi.org/10.1016/j.ajog.2020.08.108 DOI: https://doi.org/10.1016/j.ajog.2020.08.108

Bertoni I, Williams S. Approach to investigation and management of proteinuria in pregnancy. Clin Med (Lond). 2025;25(1):100281. https://doi.org/10.1016/j.clinme.2024.100281 DOI: https://doi.org/10.1016/j.clinme.2024.100281

Xiao J, Fan W, Zhu Q, Shi Z. Diagnosis of proteinuria using a random urine protein-creatinine ratio and its correlation with adverse outcomes in pregnancy with preeclampsia characterized by renal damage. J Clin Hypertens (Greenwich). 2022;24(5):652-659. https://doi.org/10.1111/jch.14467 DOI: https://doi.org/10.1111/jch.14467

Farzaneh F, Alidadi A, Payandeh A, Ajdary M, Eslahi N, Pahlavanravi A, et al. Study of The Relationship Between 24-hour Urine Protein Excretion Rate and Protein/Creatinine Ratio in Random Urine Specimen of Women with Preeclampsia. Iran J Kidney Dis. 2023;17(4):184-190. https://pubmed.ncbi.nlm.nih.gov/37634244/

Aynaoğlu Yıldız G, Topdağı Yılmaz EP. The association between protein levels in 24-hour urine samples and maternal and neonatal outcomes of pregnant women with preeclampsia. J Turk Ger Gynecol Assoc. 2022;23(3):190-198. https://doi.org/10.4274/jtgga.galenos.2022.2022-4-3 DOI: https://doi.org/10.4274/jtgga.galenos.2022.2022-4-3

Ghosh S, Tejanaik P, Sagili H, Bobby Z. Nephrotic Range Proteinuria in Preeclampsia Associated With Adverse Pregnancy Outcomes in Comparison to Non-nephrotic Range Proteinuria: A Prospective Cohort Study. Cureus. 2025;17(8):e90825. https://doi.org/10.7759/cureus.90825 DOI: https://doi.org/10.7759/cureus.90825

von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. PLoS Med. 2007;4(10):e296. https://doi.org/10.1371/journal.pmed.0040296 DOI: https://doi.org/10.1371/journal.pmed.0040296

World Medical Association. World Medical Association Declaration of Helsinki: Ethical Principles for Medical Research Involving Human Participants. JAMA. 2025;333(1):71-74. https://doi.org/10.1001/jama.2024.21972 DOI: https://doi.org/10.1001/jama.2024.21972

Shah S, Verma P. Pregnancy-Related Acute Kidney Injury: Do We Know What to Do? Nephron. 2023;147(1):35-38. https://doi.org/10.1159/000525492 DOI: https://doi.org/10.1159/000525492

Longhitano E, Siligato R, Torreggiani M, Attini R, Masturzo B, Casula V, et al. The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists. J Clin Med. 2022;11(12):3420. https://doi.org/10.3390/jcm11123420 DOI: https://doi.org/10.3390/jcm11123420

Conti-Ramsden FI, Nathan HL, De Greeff A, Hall DR, Seed PT, Chappell LC, et al. Pregnancy-Related Acute Kidney Injury in Preeclampsia: Risk Factors and Renal Outcomes. Hypertension. 2019;74(5):1144-1151. https://doi.org/10.1161/hypertensionaha.119.13089 DOI: https://doi.org/10.1161/HYPERTENSIONAHA.119.13089

Poon LC, Magee LA, Verlohren S, Shennan A, von Dadelszen P, Sheiner E, et al. A literature review and best practice advice for second and third trimester risk stratification, monitoring, and management of pre-eclampsia: Compiled by the Pregnancy and Non-Communicable Diseases Committee of FIGO (the International Federation of Gynecology and Obstetrics). Int J Gynaecol Obstet. 2021;154 Suppl 1:3-31. https://doi.org/10.1002/ijgo.13763 DOI: https://doi.org/10.1002/ijgo.13763

Kountouris E, Clark K, Kay P, Roberts N, Bramham K, Kametas NA. Postnatal assessment for renal dysfunction in women with hypertensive disorders of pregnancy: A prospective observational study. J Nephrol. 2021;34(5):1641-1649. https://doi.org/10.1007/s40620-021-01134-7 DOI: https://doi.org/10.1007/s40620-021-01134-7

Srialluri N, Surapaneni A, Chang A, Mackeen AD, Paglia MJ, Grams ME. Preeclampsia and Long-term Kidney Outcomes: An Observational Cohort Study. Am J Kidney Dis. 2023;82(6):698-705. https://doi.org/10.1053/j.ajkd.2023.04.010 DOI: https://doi.org/10.1053/j.ajkd.2023.04.010

Shapiro J, Ray JG, McArthur E, Jeyakumar N, Chanchlani R, Harel Z, et al. Risk of Acute Kidney Injury After Hypertensive Disorders of Pregnancy: A Population-Based Cohort Study. Am J Kidney Dis. 2022;79(4):561-569. https://doi.org/10.1053/j.ajkd.2021.07.017 DOI: https://doi.org/10.1053/j.ajkd.2021.07.017

portadaaart3

Downloads

Published

2026-10-31

Data Availability Statement

The aggregate data supporting the reported analyses are presented in the article. Additional information about the extraction form and tabulated results may be requested from the corresponding author upon reasonable request. Access to individual clinical records is subject to institutional approval and applicable confidentiality requirements.

Issue

Section

Original Research

How to Cite

1.
Gabriel-Huamanchumo BB, Garamendi-Sacsara VS. Twenty-four-hour proteinuria and acute kidney injury in women with preeclampsia in Peru. TUMI Health Sci Res [Internet]. 2026 Oct. 31 [cited 2026 Nov. 5];1(2):15-21. Available from: https://tumijournal.com/index.php/health-sciences-research/article/view/41