Table 1.
Diagnostic criteria for preeclampsia: Diagnosis requires one essential and one additional clinical feature for diagnosis
| Diagnostic Criteria | Preeclampsia | Preeclampsia in Women with CKD |
|---|---|---|
| Essential | >20 wk gestation | |
| New hypertension: systolic BP ≥140 mm Hg or diastolic BP ≥90 mm Hg on two occasions | Hypertension: | |
| • In women without chronic hypertension: as for preeclampsia | ||
| • In women with chronic hypertension: no diagnostic threshold, de novo severe BP (systolic BP >160 mm Hg or diastolic BP >110 mm Hg) or an increase in treatment to maintain BP<160/110 mm Hg used in research cohorts (5,9) | ||
| Additional | Proteinuria: | Proteinuria: |
| • UPCR≥0.3 mg/mg (>30 mg/mmol) | • In women with nonproteinuric CKD: as for preeclampsia | |
| • >300 mg/24 h (not indicated if UPCR available) | • In women with proteinuric CKD: no diagnostic threshold, | |
| • Dipstick >2+ (if other methods unavailable) | >100% increase and UPCR≥0.3 mg/mg (>30 mg/mmol) used in research cohorts (5,9) | |
| • UACR>70 mg/g (>8 mg/mmol) (54,75) | ||
| Serum creatinine: | Serum creatinine: | |
| • Serum creatinine >1.0a to 1.1 mg/dlb,c | • In women with CKD and preserved excretory function: as for preeclampsia | |
| • Doubling of serum creatinine <1.1 mg/dlb,c | • In women with CKD and abnormal prepregnancy function: no consensus on diagnostic threshold for change in creatinine, >50% increase within 7 d used in research cohorts (5) | |
| Hematologic complications: | ||
| • Platelets <100b–150a×109/Lc | ||
| • Hemolysisc, disseminated intravascular coagulationc | ||
| Liver complications: | ||
| • AST or ALT >40 IU/La or double normal reference limitb,c | ||
| • Epigastric/right upper quadrant pain (not attributable to alternate diagnosis)c | ||
| Neurologic complications: | ||
| • Eclampsiac | ||
| • Altered mental statusc | ||
| • Blindness, persistent visual scotomatac | ||
| • Strokec | ||
| • Clonus | ||
| • New-onset headache not attributable to alternate diagnosisc | ||
| Respiratory complications: | ||
| • Pulmonary edema not attributable to another diagnosisc | ||
| Uteroplacental dysfunction: | ||
| • Fetal growth restriction, abnormal umbilical artery Doppler waveform, stillbirth | ||