Effect of posture on creatinine clearance in late pregnancy and after pregnancy

Abstract

Aim: To assess creatinine clearance that indicates glomerular filtration rate (GFR) and to demonstrate the effect of posture on creatinine clearance in late pregnancy compared to the non-pregnant state. Methods: Twenty-six healthy pregnant women aged 19-30 years were studied for two sessions, first in their third trimester of pregnancy and then in a non-pregnant state at 6-12 weeks after delivery. In both sessions, creatinine clearance was assessed at three periods: the 24-h baseline, and at the end of 2-h sitting and 2-h lying (in left lateral decubitus position) periods. Urine and blood samples were collected for creatinine clearance measurement. Results: The results showed that the 24-h creatinine clearance in late pregnancy was 28.3% higher than that in the non-pregnant state (122.6 ± 26.2 vs 95.3 ± 15.1 mL/min per 1.73 m2, P < 0.001). In late pregnancy, after 2-h sitting, creatinine clearance decreased significantly (10%) compared to the 24-h baseline (122.6 ± 26.2 vs 110.4 ± 28.6 mL/min per 1.73 m2, P < 0.001). Creatinine clearance rose back to the high baseline level after the pregnant woman laid in left lateral decubitus for 2 h. The decrease in creatinine clearance during prolonged sitting was not seen in the non-pregnant state. At any posture, the creatinine clearance was always higher in the pregnant state than in the non-pregnant. Conclusions: This study showed that creatinine clearance in late pregnancy was much higher than in the non-pregnant state, and was affected by sitting for up to 2 h. It might be wise for women to lay down in the left lateral decubitus position for a while after many hours of sitting when pregnancy is approaching its term. © 2007 The Authors.