Proteinuria in pregnancy-Review

Abstract

Proteinuria is a cardinal sign of kidney damage and a risk factor for kidney disease progression. Urinary protein excretion increases during normal pregnancy. In the recent recommendations proteinuria is no longer a mandatory diagnostic feature of preeclampsia. Since most published data are based on proteinuria being a requirement for the diagnosis of preeclampsia, removal of proteinuria renders a substantial body of evidence in need of revision. We conducted a thorough search of the literature using appropriate Mesh terms. Most published data points towards a favorable outcome of proteinuria during pregnancy. However, apart from some reports of retrospective studies, no strong evidence exists that this applies to the long-term kidney outcome. Since blood pressure is known to dip in the first trimester of pregnancy, blood pressure elevation from its nadir to the current cut off of 140/90 mmHg may be regarded as "unrecognized prodrome". More research work is needed to find more sensitive tools for screening at-risk population in genomic, proteomic, clinical and epidemiological domains.