Study Results
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Basic Information
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COMPLETED
48 participants
OBSERVATIONAL
2015-07-31
2016-07-31
Brief Summary
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Detailed Description
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Physiological changes in pregnancy predispose patients to urinary tract infections; ureteral compression by the gravid uterus, progesterone-mediated slowing of ureteral peristalsis and decreased bladder tone, and mechanical compression of the bladder contribute to impaired clearance of bacteria from the urinary tract. Indeed, acute cystitis complicates 2-4% of all pregnancies. While it has been said that urinary tract infections increase proteinuria, it is unknown how much protein spillage should be expected in the general or the pregnant populations. Hence a patient with pyelonephritis may obscure the diagnosis of preeclampsia if she spills urinary protein from her infection.
The purpose of this study is to compare the mean of 24-hour urine protein in pregnant patients with and without acute pyelonephritis.
The importance of this study will be to determine if urine protein excretion is in fact increased in the setting of pyelonephritis. This will allow for reliable evaluation of urine protein during the work up for preeclampsia in those women also found having a kidney infection.
Conditions
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Study Design
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CASE_CONTROL
PROSPECTIVE
Study Groups
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Pyelonephritis Group
patients with pyelonephritis
Exposure to pyelonephritis
Pyelonephritis group are patients with exposure to pyelonephritis Without pyelonephritis group are patients without pyelonephritis
Without pyelonephritis Group
patients without pyelonephritis
No interventions assigned to this group
Interventions
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Exposure to pyelonephritis
Pyelonephritis group are patients with exposure to pyelonephritis Without pyelonephritis group are patients without pyelonephritis
Eligibility Criteria
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Inclusion Criteria
* Gestational age between 20 weeks and 0 days to 41 weeks and 0 days
* Singleton pregnancy
* Pyelonephritis group:
meeting 2 out of 3 criteria:
1. Fever \> 100.4
2. Costovertebral angle tenderness
3. Positive urine culture - without pyelonephritis group: without acute cystitis and pyelonephritis
Positive culture defined as: quantitative count of ≥ 100,000 CFU/mL or single catheterized urine specimen with quantitative count of 100 CFU/mL.
Exclusion Criteria
* Pre-gestational diabetes
* Autoimmune disorders
* Preexisting renal disease
* Multiple gestation
* Vaginal bleeding
* Preeclampsia
* Hospital admission \> 3 days
18 Years
FEMALE
No
Sponsors
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MemorialCare Health System
OTHER
Responsible Party
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Kenneth Chan, MD
Maternal Fetal Medicine
Principal Investigators
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Kenneth Chan, MD
Role: PRINCIPAL_INVESTIGATOR
Maternal Fetal Medicine
Locations
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Miller Children's and Women's Hospital at Long Beach Memorial Medical Center
Long Beach, California, United States
Countries
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References
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Lindheimer MD, Kanter D. Interpreting abnormal proteinuria in pregnancy: the need for a more pathophysiological approach. Obstet Gynecol. 2010 Feb;115(2 Pt 1):365-375. doi: 10.1097/AOG.0b013e3181cb9644.
Osmundson SS, Lafayette RA, Bowen RA, Roque VC, Garabedian MJ, Aziz N. Maternal proteinuria in twin compared with singleton pregnancies. Obstet Gynecol. 2014 Aug;124(2 Pt 1):332-337. doi: 10.1097/AOG.0000000000000383.
Gilstrap LC 3rd, Ramin SM. Urinary tract infections during pregnancy. Obstet Gynecol Clin North Am. 2001 Sep;28(3):581-91. doi: 10.1016/s0889-8545(05)70219-9.
Jolley JA, Wing DA. Pyelonephritis in pregnancy: an update on treatment options for optimal outcomes. Drugs. 2010 Sep 10;70(13):1643-55. doi: 10.2165/11538050-000000000-00000.
Carter JL, Tomson CR, Stevens PE, Lamb EJ. Does urinary tract infection cause proteinuria or microalbuminuria? A systematic review. Nephrol Dial Transplant. 2006 Nov;21(11):3031-7. doi: 10.1093/ndt/gfl373. Epub 2006 Jul 22. No abstract available.
Rubin RH, Shapiro ED, Andriole VT, Davis RJ, Stamm WE. Evaluation of new anti-infective drugs for the treatment of urinary tract infection. Infectious Diseases Society of America and the Food and Drug Administration. Clin Infect Dis. 1992 Nov;15 Suppl 1:S216-27. doi: 10.1093/clind/15.supplement_1.s216.
Nicolle LE, Bradley S, Colgan R, Rice JC, Schaeffer A, Hooton TM; Infectious Diseases Society of America; American Society of Nephrology; American Geriatric Society. Infectious Diseases Society of America guidelines for the diagnosis and treatment of asymptomatic bacteriuria in adults. Clin Infect Dis. 2005 Mar 1;40(5):643-54. doi: 10.1086/427507. Epub 2005 Feb 4. No abstract available.
CLARK LC, THOMPSON H, BECK EI. The excretion of creatine and creatinine during pregnancy. Am J Obstet Gynecol. 1951 Sep;62(3):576-83. doi: 10.1016/0002-9378(51)91156-8. No abstract available.
Hypertension in pregnancy. Report of the American College of Obstetricians and Gynecologists' Task Force on Hypertension in Pregnancy. Obstet Gynecol. 2013 Nov;122(5):1122-1131. doi: 10.1097/01.AOG.0000437382.03963.88. No abstract available.
Other Identifiers
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510-15
Identifier Type: -
Identifier Source: org_study_id
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