Normal-range urinary albumin excretion associates with blood pressure and renal electrolyte handling in pregnancy


  • A. Birukov
  • M.S. Andersen
  • J.S. Jørgensen
  • G. Kitlen
  • N. Rakova
  • J.H. Nielsen
  • L.B. Andersen
  • R. Dechend
  • B.L. Jensen


  • American Journal of Physiology Renal Physiology


  • Am J Physiol Renal Physiol 319 (1): F1-F7


  • BACKGROUND: Albuminuria in the pathological range is a significant predictor of preeclampsia. In healthy persons, high-normal urine albumin predicts later incidence of hypertension and is associated with salt-sensitivity of blood pressure. We hypothesized that in pregnancy urine albumin in the normal range associates with blood pressure through activation of distal sodium reabsorption and renal salt retention by plasma factors co-filtered with albumin. METHODS: We analyzed 24-hour urine collections and plasma samples from gestational week 29 of 560 pregnant women from the Odense Child Cohort, a Danish population-based cohort. Plasma and urine aldosterone were measured by ELISA. Plasma and urine sodium, potassium, chloride and creatinine were also determined. Predictive values of urine albumin were assessed by linear mixed, multiple and Cox regression analyses. Primary outcomes were blood pressure and renal electrolyte handling. RESULTS: 24h urinary albumin excretion at gestational week 29 associated with gestational blood pressure trajectory, adjusted β coefficients (95% CI) for each 10-fold increase in urine albumin: 5.71 (1.60 to 9.81) mmHg for systolic and 4.39 (1.41 to 7.38) mmHg for diastolic blood pressure. Urine albumin was inversely associated with fractional excretion rates of sodium, potassium and chloride, adjusted β coefficients (95% CI) for each 10-fold increase in urine albumin: -0.25 (-0.35 to -0.14), -5.06 (-6.81 to -3.30) and -0.28 (-0.41 to -0.15), respectively. CONCLUSIONS: At gestational week 29, urinary albumin excretion in the normal range associated with blood pressure and renal electrolyte handling independent of potential confounders.