CHIATECH JOURNAL · Registered Version of Record

Renal Biochemical Signatures of Pregnancy-Induced Hypertension in Tertiary Antenatal Care in Enugu State, Nigeria: Electrolyte, Urea–Creatinine and Plasma-Protein Profiles

1. Cephasking Ogbotu Emmanuel
   ¹ Department of Biochemistry, Joseph Sarwuan Tarka University, Makurdi, Nigeria; original study investigator (research completed 2021)

Abstract

Background: Hypertensive disorders of pregnancy remain a major maternal–fetal health problem in Nigeria, and renal involvement is clinically important because pre-eclampsia can alter renal perfusion, glomerular filtration and protein handling before conventional azotemia becomes prominent. Objective: To characterize serum electrolytes, nitrogenous-waste markers and plasma proteins in women with pregnancy-induced hypertension (PIH) compared with normotensive pregnant women across gestation, using the completed 2021 tertiary-hospital study as the primary evidence base and contemporary guidance for interpretation. Methods: The archived study recruited pregnant women aged 24–36 years attending the University of Nigeria Teaching Hospital and Enugu State University Teaching Hospital. The listed analytic groups comprised 149 women: normotensive first trimester (n=30), normotensive second trimester (n=30), normotensive third trimester (n=30), hypertensive second trimester (n=30) and hypertensive third trimester (n=29). Serum Na⁺, K⁺, Cl⁻, HCO₃⁻, urea, creatinine, total protein, albumin and globulin were assessed by documented colorimetric/titrimetric methods. The source analysis used one- and two-way ANOVA, Duncan multiple-range testing and SPSS v24, with p<0.05 as significant. Results: The original analysis found no significant between-group differences in Na⁺, K⁺, Cl⁻, HCO₃⁻, urea or creatinine (all reported p>0.05), although urea and creatinine were numerically higher in the hypertensive third-trimester group than in the corresponding normotensive group. In contrast, total protein, albumin and globulin were significantly lower in hypertensive groups (p<0.05). Digitization of the archived figures places albumin at approximately 31.4 g/L in hypertensive second trimester and 27.7 g/L in hypertensive third trimester, versus approximately 43.6 and 40.4 g/L in trimester-matched normotensive groups. Conclusion: The completed cohort shows a biochemical phenotype dominated by plasma-protein depletion rather than overt electrolyte failure or statistically demonstrable azotemia. Contemporary interpretation requires caution: preserved serum creatinine and electrolytes do not exclude pre-eclamptic renal involvement, and the study did not quantify urine protein. Current practice should integrate blood pressure with urine protein:creatinine or albumin:creatinine ratio, serum creatinine and broader maternal-organ assessment.

Keywords: pregnancy-induced hypertension; pre-eclampsia; renal biochemistry; creatinine; albumin; total protein; electrolytes; Nigeria; Enugu State

Licence: CC BY 4.0

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