Serum Uric Acid and Uric Acid Creatinine Ratio as Emerging Indicators of Renal Adaptation and Risk in Pregnancy

Abstract

Background: Serum uric acid has emerged as a clinically relevant biomarker in pregnancy due to its association with renal function, oxidative stress, and hypertensive disorders such as preeclampsia. The uric acid–creatinine ratio has been proposed as a more sensitive indicator of renal adaptation, as it accounts for variations in glomerular filtration. Objective: This study evaluated serum uric acid levels and the uric acid–creatinine ratio as indicators of renal adaptation among pregnant women in Port Harcourt, Nigeria, and compared findings with non-pregnant controls. Methods: A cross-sectional analytical study was conducted among 150 women, comprising 90 pregnant women (30 per trimester) and 60 non-pregnant controls. Blood samples were collected and analyzed for creatinine, urea, electrolytes, and uric acid using standard laboratory methods. The uric acid–creatinine ratio was calculated. Data were analyzed using SPSS version 24, with statistical significance set at p < 0.05. Results: Pregnant women had significantly higher levels of creatinine, urea, potassium, chloride, bicarbonate, uric acid, and uric acid–creatinine ratio compared to non-pregnant controls (p < 0.05), while sodium levels showed no significant difference. Across trimesters, creatinine increased significantly (p = 0.026), and chloride decreased in the third trimester (p = 0.043). Uric acid levels and derived ratios did not vary significantly across trimesters. Age-related analysis showed a significant decline in potassium levels with increasing age (p = 0.032). Conclusion: Serum uric acid and the uric acid–creatinine ratio are elevated in pregnancy and reflect important renal adaptations. These biomarkers may serve as useful, cost-effective tools for monitoring renal function and identifying early risk of pregnancy-related complications.