Evaluation of Liver and Renal Functions Tests in Pregnant Women with Preeclampsia

Download Article

DOI: 10.21522/TIJPH.2013.13.01.Art057

Authors : Ali M. Al-Sultan, Muna H. Jankeer

Abstract:

This study aimed to evaluate the biochemical role of liver functions (activity of liver enzymes and proteins) and kidneys (urea and creatinine) in the serum of pregnant women with preeclampsia. A total of 60 blood samples from pregnant women with preeclampsia and hypertension during pregnancy, and 35 healthy pregnant women with matched age and pregnancy stage (control group) were collected and serum separated. Liver and renal function tests were measured, these included serum alkaline phosphate enzyme activity (ALP), alanine aminotransferase activity (ALT), aspartate aminotransferase activity (AST), Gamma-glutamyl transferase activity (GGT), serum total protein, serum albumin, urea test, and Creatinine test. These parameters were significantly (p<0.05) higher in preeclampsia patients compared to the control group. Differences were noticed between the second and third trimesters of pregnancy, and an association was also reported between older age compared to younger. In conclusion, liver and renal function were affected by pregnancy with greater association with preeclampsia in pregnant women and the ageing process has a more aggressive impact on renal and liver abnormalities.

References:

[1].   Cruickshank, T., MacDonald, T. M., Walker, S. P., Keenan, E., Dane, K., Middleton, A., Kaitu’u‐Lino, T. U. J., 2021, Circulating growth differentiation factor 15 is increased preceding preeclampsia diagnosis: implications as a disease biomarker. Journal of the American Heart Association, 10(16), e020302, doi:10.1161/JAHA.120.020302.

[2].   Yakut, K., Öcal, D. F., Öztürk, F. H., Öztürk, M., Oğuz, Y., Sınacı, S., Çağlar, T., 2021, Is GDF-15 level associated with gestational diabetes mellitus and adverse perinatal outcomes? Taiwanese Journal of Obstetrics and Gynecology, 60(2), 221-224, doi:10.1016/j.tjog.2020.12.004.

[3].   Masnavi, E., Hosseini, M., Aramesh, S. H., Hassanzadeh, S., 2022, Relationship between Vitamin D and Preeclampsia in Pregnant Women: A Comparative Descriptive Study. Journal of Clinical Care and Skills, 3(2), 67-71, doi:10.52547/jccs.3.2.67.

[4].   Chen, Y., Wu, L., Liu, H., Li, Z., Li, L., Wu, X., Niu, J., 2023, Third‐trimester maternal serum chemerin and hypertension after preeclampsia: a prospective cohort study. Journal of the American Heart Association, 12(5), e027930. doi:10.1161/JAHA.122.027930.

[5].   Singh, S., Moodley, J., Khaliq, O. P., Naicker, T., 2021, a narrative review of the renin-angiotensin-aldosterone system in the placenta and placental bed of HIV infected women of African ancestry with preeclampsia. Current Hypertension Reports, 23(8), 39, doi:10.1007/s11906-021-01158-1.

[6].   Dankova, M., Minarikova, Z., Danko, J., Gergel, J., Pontuch, P., Goncalvesova, E., 2020, Novel biomarkers for prediction of acute kidney injury in acute heart failure. Bratislavske Lekarske Listy, 121(5), 321-324. doi:10.4149/bll_2020_050.

[7].   Amosco, M. D., Tavera, G. R., Villar, V. A. M., Naniong, J. M. A., David-Bustamante, L. M. G., Williams, S. M., Palmes-Saloma, C. P., 2019, Non-additive effects of ACVR2A in preeclampsia in a Philippine population. BMC Pregnancy and Childbirth, 19, 1-8, doi:10.1186/s12884-018-2152-z.

[8].   Terada, Y., Yayama, K., 2021, Angiotensin II-induced vasoconstriction via Rho kinase activation in pressure-overloaded rat thoracic aortas. Biomolecules, 11(8), 1076. doi:10.3390/biom11081076.

[9].   Zainiyah, Z., Susanti, E., Wulandari, N., 2022, Identification of Polymorphism Angiotensin Ii Type 1 Receptor (AT1) 1166 A/C Gene and Potassium Levels in Pre-Eclampsia among The Madurese Population, doi:10.52711/0974-360X.2024.00349.

[10].  Sumathi, M. E., Joshi, R. U., Gomathy, E., Shashidhar, K., 2016, Usefulness of serum gamma glutamyl transferase in assessing severity of preeclampsia. Int J Clin Biochem Res, 3(2), 245-9, doi:10.5958/2394-6377.2016.00047.2.

[11].  Teklemariam, A. B., Wabalo, E. K., Leta, T. A., Assefa, S. S., Abebe, E. C., 2022, Evaluation of lactate dehydrogenase and gamma Glutamyl transferase among pregnant women with hypertensive disorders and their association with disease severity in Jimma medical center, Ethiopia. Journal of Obstetrics, Gynecology and Cancer Research, 7(6), 497-509, doi:10.30699/jogcr.7.6.497.

[12].  Saleem, F. R., Chandru, S., Biswas, M., 2020, Evaluation of total LDH and its isoenzymes as markers in preeclampsia. Journal of Medical Biochemistry, 39(3), 392, doi: 10.2478/jomb-2019-0045.

[13].  Elias, S. E. S., Eltom, A., Osman, A. L., Babker, A. M., 2018, Gamma glutamyl transferase and lactate dehydrogenase as biochemical markers of severity of preeclampsia among Sudanese pregnant women. Int J Reprod Contracept Obstet Gynecol, 7(8), 3020-3, doi:10.18203/2320-1770.ijrcog20183294.

[14].  Shojaei, K., Jafari, R. M., Haghighat, F., 2019, Comparison of the level of uric acid and LDH in mothers in early and late preeclampsia and determination of its association with the severity of preeclampsia. Journal of Biochemical Technology, 10(2-2019), 36-41.

[15].  Lee, D. H., Blomhoff, R., Jacobs, D. R., 2004, Review is serum gamma glutamyltransferase a marker of oxidative stress? Free radical research, 38(6), 535-539. doi:10.1080/10715760410001694026.

[16].  Mehta, M., Parashar, M., Kumar, R., 2019, Serum lactate dehydrogenase: a prognostic factor in pre-eclampsia. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 8(7), 2792-2799. https://link.gale.com/apps/doc/A597716014/HRCA?u=anon~dd27f547&sid=googleScholar&xid=90df6f5d [accessed 23 Nov 2024].

[17].  Patil, R. R., Choudhari, A. S., 2016, Evaluation of activities of serum gamma GLUTAMYL transferase and adenosine deaminase in pre-eclampsia-a CASE control study. National Journal of Medical Research, 6(04), 313-315. https://njmr.in/index.php/file/article/view/223

[18].  Wu, J., Zhou, W., Li, Q., Yuan, R., Li, H., Cui, S., 2017, Combined use of serum gamma glutamyl transferase level and ultrasonography improves prediction of perinatal outcomes associated with preeclamptic pregnancy. Clinica Chimica Acta, 475, 97-101, doi:10.1016/j.cca.2017.09.018.

[19].  Popovski, N., Nikolov, A., 2019, Practice Bulletin of the American College of Obstetrics and Gynaecologists 2019 on Magement of Hypertensive Disorders in Pregnancy-A Short Review of the Current Recommendations. Biomedical Journal of Scientific & Technical Research, 23(2), 17198-17201, doi:10.26717/BJSTR.2019.23.003861.

[20].  Agbana, R. D., Sanni, T. A., Adeyanju, B. T., Ipinnimo, T. M., Aderinwale, O. A., Adetona, A., 2024, Knowledge and Prevalence of Hepatitis B Virus Infection among Pregnant Women attending Antenatal Care Services at Federal Teaching Hospital Ido-Ekiti, Ekiti State, Southwest Nigeria, Texila International Journal of Public Health, 12(2):1-11, doi:10.21522/TIJPH.2013.12.02.Art004.

[21].  Braunthal, S., Brateanu, A., 2019, Hypertension in pregnancy: Pathophysiology and treatment. SAGE Open Medicine, 7, 2050312119843700, doi:10.1177/2050312119843700.

[22].  Arora, E., Juron, T., Fuks, A., Salafia, C., 2022, Extreme Elevation of Alkaline Phosphatase in a Pregnancy Complicated by Uncontrolled Chronic Hypertension and Its Association with Placental Pathology. Journal of Endocrinology and Metabolism, 12(1), 49-52, doi: doi:10.14740/jem789.

[23].  Demir, S. C., Evruke, C., Ozgunen, F. T., Urunsak, I. F., Candan, E., Kadayifci, O., 2006, Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome. Saudi Medical Journal, 27(7), 1015.

[24].  Ali, S. A., 2024, Prevalence and Potential Risks Associated with Utilization of Medication During Pregnancy-A Cross-Sectional Study. Texila International Journal of Public Health, 12(2). doi:10.21522/TIJPH.2013.12.02.Art009.

[25].  Dacaj, R., Izetbegovic, S., Stojkanovic, G., Dreshaj, S., 2016, Elevated liver enzymes in cases of preeclampsia and intrauterine growth restriction. Medical Archives, 70(1), 44, doi: 10.5455/medarh.2016.70.44-47.

[26].  Ferreira, R. C., Fragoso, M. B. T., dos Santos Tenório, M. C., da Paz Martins, A.S., Borbely, A. U., Moura, F. A., de Oliveira, A. C. M., 2020, Biomarkers of placental redox imbalance in pregnancies with preeclampsia and consequent perinatal outcomes. Archives of Biochemistry and Biophysics, 691, 108464, doi:10.1016/j.abb.2020.108464.

[27].  Kattah, A., 2020, Preeclampsia and kidney disease: deciphering cause and effect. Current Hypertension Reports, 22(11), 91, doi:10.1007/s11906-020-01099-1.

[28].  Shaheen, A., Luqman, M. W., Iqbal, S., Khan, N., Fatima, S., Nazli, R. 2022, Relationship of serum visfatin levels with serum electrolytes, liver profile, hepatic enzymes and anthropometric parameters in pregnant women with preeclampsia and eclampsia during 3rd trimester. Journal of Ayub Medical College, Abbottabad: JAMC, 34(1), 62-66, doi:10.55519/JAMC-01-8975.

[29].  Westbrook, R. H., Dusheiko, G., Williamson, C., 2016, Pregnancy and liver disease. Journal of hepatology, 64(4), 933-945, doi:10.1016/j.jhep.2015.11.030.

[30].  Ganai, I., Samoon, S. J., Nafae, P., Arifkelam, Ganie, F. A., 2014, To Study the biochemical and hematological parameters in pre-eclampsia. Journal of Medical Science and Clinical Research, 2014;2(1):315-321.

[31].  Serra, B., Mendoza, M., Scazzocchio, E., Meler, E., Nolla, M., Sabrià, E., Carreras, E., 2020, A new model for screening for early-onset preeclampsia. American Journal of Obstetrics and Gynecology, 222(6), 608-e1, doi:10.1016/j.ajog.2020.01.020.

[32].  Iacobelli, S., Guignard, J. P., 2021, Maturation of glomerular filtration rate in neonates and infants: an overview. Pediatric Nephrology, 36(6), 1439-1446, doi:10.1007/s00467-020-04632-1.

[33].  Kavuru, V., Vu, T., Karageorge, L., Choudhury, D., Senger, R., Robertson, J., 2020, Dipstick analysis of urine chemistry: benefits and limitations of dry chemistry-based assays. Postgraduate Medicine, 132(3), 225-233. doi:10.1080/00325481.2019.1679540.

[34].  Zhang, B., Chen, X., Yang, C., Shi, H., Xiu, W., 2024, Effects of hypertensive disorders of pregnancy on the complications in very low birth weight neonates. Hypertension in Pregnancy, 43(1), 2314576, doi:10.1080/10641955.2024.2314576.

[35].  Nielsen, S. T., Strandkjær, N., Juul Rasmussen, I., Hansen, M. K., Lytsen, R. M., Kamstrup, P. R., Frikke-Schmidt, R., 2022, Coagulation parameters in the newborn and infant–the Copenhagen Baby Heart and COMPARE studies. Clinical Chemistry and Laboratory Medicine, 60(2), 261-270, doi:10.1515/cclm-2021-0967.

[36].  Tinta, Y., Polopadang, V., Rais MuhKardi, S., 2020, Related Factors to Preeclampsia Incidence in Pregnant Women at Lasinrang Regional Hospital Pinrang. South Asian Research Journal of Nursing and Healthcare, 02(01):12–6, doi:10.36346/sarjnhc.2020.v02i01.002.

[37].  Hercus, A., Dekker, G., Leemaqz, S., 2020, Primipaternity and birth interval; independent risk factors for preeclampsia. The Journal of Maternal-fetal and Neonatal Medicine, 33(2), 303-306, doi:10.1080/14767058.2018.1489794.

[38].  Ekun, O. A., Olawumi, O. M., Makwe, C. C., Ogidi, N. O., 2018, Biochemical assessment of renal and liver function among preeclamptics in lagos metropolis. International Journal of Reproductive Medicine, 2018(1), 1594182, doi:10.1155/2018/1594182.

[39].  Nasonova, S. N., Zhirov, I. V., Ledyakhova, M. V., Sharf, T. V., Bosykh, E. G., Masenko, V. P., Tereshchenko, S. N., 2019, Early diagnosis of acute renal injury in patients with acute decompensation of chronic heart failure. Terapevticheskii arkhiv, 91(4), 67-73. doi:10.26442/00403660.2019.04.000168.

[40].  Jose, H., Salazar, M., 2014, Overview of urea and creatinine. Lab. Med., 45(1): 19-20, doi:10.1309/LM920SBNZPJRJGUT.

[41].  Tangren, J. S., Wan Md Adnan, W. A. H., Powe, C. E., Ecker, J., Bramham, K., Hladunewich, M. A., Thadhani, R., 2018, Risk of preeclampsia and pregnancy complications in women with a history of acute kidney injury. Hypertension, 72(2), 451-459, doi:10.1161/HYPERTENSIONAHA.118.11161.

[42].  Tavakoli, H., Rostami, H., Avan, A., Bagherniya, M., Ferns, G. A., Khayyatzadeh, S. S., Ghayour‐Mobarhan, M., 2019, High dose vitamin D supplementation is associated with an improvement in serum markers of liver function. Biofactors, 45(3), 335-342, doi:10.1002/biof.1496.

[43].  Aghsaeifard, Z., Alizadeh, R., Bagheri, N., 2022, Association between neutrophil gelatinase-associated lipocalin (NGAL) and iron profile in chronic renal disease. Archives of Physiology and Biochemistry, 128(3), 703-707, doi:10.1080/13813455.2020.1720742.

[44].  Fiseha, T., Mengesha, T., Girma, R., Kebede, E., Gebreweld, A., 2019, Estimation of renal function in adult outpatients with normal serum creatinine. BMC Research Notes, 12, 1-6, doi:10.1186/s13104-019-4487-6.

[45].  Chung, E. Y., Trinh, K., Li, J., Hahn, S. H., Endre, Z. H., Rogers, N. M., Alexander, S. I., 2022, Biomarkers in cardiorenal syndrome and potential insights into novel therapeutics. Frontiers in Cardiovascular Medicine, 9, 868658. doi:10.3389/fcvm.2022.868658.

[46].   Zhang, C., Zhang, D. D., Feng, Y. M., Huang, Z.Q., Xie, Y. B., Zhou, J., Li, J., 2022, Relationship between morning peak phenomenon and early renal injury NGAL in H-type hypertension. Blood Pressure, 31(1), 200-206, doi:10.1080/08037051.2022.2106186