title: Feasibility of nephrinuria as a screening tool for the risk of pre-eclampsia: prospective observational study.
abstract: To investigate the possibility of nephrinuria as a screening tool for the risk of pre-eclampsia (PE).
  
  
  
  Prospective observational study.
  
  
  
  A single university hospital. Changes in urinary nephrin:creatinine ratio (NCR, ng/mg) and protein:creatinine ratio (PCR, mg/mg) in pregnancy were determined. Significant proteinuria in pregnancy (SPIP) was defined as PCR>0.27. PE was diagnosed in women with both SPIP and hypertension.
  
  
  
  89 pregnant women in whom neither hypertension nor SPIP was present at enrolment, providing 31, 125 and 93 random urine samples during first, second and third trimesters, respectively.
  
  
  
  PE developed in 14 of the 89 women. NCR increased with increasing PCR in 14 women with PE (correlation coefficient, 0.862; p<0.0001). In contrast, NCR did not change significantly despite significant increases in PCR in 75 women with normotensive pregnancies defined as neither SPIP nor hypertension, indicating that there was little increase in nephrinuria over the physiological range of proteinuria in pregnancy. Relative risk of later development of PE among asymptomatic second and third trimester women with NCR (ng/mg) >122 (95th centile value for 75 women with normotensive pregnancies) was 5.93 (95% CI 2.59 to 13.6; 60% (6/10) vs 10% (8/79)) and 13.5 (95% CI 3.31 to 55.0; 75% (6/8) vs 5.5% (2/36)), respectively, compared with women with NCR≤122 at that time.
  
  
  
  Nephrinuria was unlikely to increase in normal pregnancy. A certain NCR cut-off may efficiently differentiate women at higher risk of PE.
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Tianyue
authors.initials: T
authors.lastname: Zhai
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Itsuko
authors.initials: I
authors.lastname: Furuta
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Rina
authors.initials: R
authors.lastname: Akaishi
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Kawabata
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Chiba
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Umazume
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ishikawa
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Mamoru
authors.initials: M
authors.lastname: Morikawa
authors.affiliation: Department of Obstetrics, Hokkaido University Graduate School of Medicine, Sapporo, Hokkaido, Japan.
authors.forename: Hisanori
authors.initials: H
authors.lastname: Minakami
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000652:urine; D003404:Creatinine / Q000652:urine; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000175:diagnosis; D008565:Membrane Proteins / Q000652:urine*; D010298:Parity; D011225:Pre-Eclampsia / Q000175:diagnosis*; D011247:Pregnancy; D011264:Pregnancy Trimesters; D011296:Prenatal Diagnosis / Q000379:methods; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis; D018570:Risk Assessment; D055815:Young Adult
chemical_list: D015415:Biomarkers; D008565:Membrane Proteins; C113267:nephrin; D003404:Creatinine
keywords: nephrin; podocyte injury; preeclampsia; proteinuric diseases; urine test