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preeclampsia and kidney

Min Jeong Kim, Joo Hui Kim, Il Young Kim, Soo Bong Lee, In Seong Park, Mi Yeun Han, Harin Rhee, Sang Heon Song, Eun Young Seong, Ihm Soo Kwak, Dong Won Lee
Preeclampsia is the most common cause of proteinuria with hypertension during pregnancy. Primary kidney disease and kidney disease secondary to systemic disorders may rarely occur during pregnancy, resulting in proteinuria. A 34-year-old woman was admitted to our hospital with abdominal distention and lower extremity edema. The pregnancy was terminated at the 24th week of gestation due to preterm labor. Even after the delivery, proteinuria and renal deterioration continued to progress. The M-peak was not found on serum and urine protein electrophoresis...
March 2018: Iranian Journal of Kidney Diseases
Olina Dagher, Nassiba Alami Laroussi, Michel Carrier, Renzo Cecere, Eric Charbonneau, Simon de Denus, Nadia Giannetti, Line Leduc, Bernard Cantin, Asmaa Mansour, Nancy Poirier, Marie-Josée Raboisson, Michel White, Anique Ducharme
BACKGROUND: Despite reports of successful pregnancies in heart transplant (HTx) recipients, many centers recommend their patients against maternity. METHODS: We reviewed our provincial experience of pregnancy in HTx recipient by performing charts review of all known gestations following HTx in the province of Quebec (Canada), stratified between planned and unplanned pregnancies. Long-term survival was compared to HTx recipient women of childbearing age who didn't become pregnant...
February 26, 2018: Transplant International: Official Journal of the European Society for Organ Transplantation
Jessica Sheehan Tangren, Camille E Powe, Jeffrey Ecker, Kate Bramham, Elizabeth Ankers, S Ananth Karumanchi, Ravi Thadhani
BACKGROUND AND OBJECTIVES: Kidney stones are associated with future development of hypertension, diabetes, and the metabolic syndrome. Our objective was to assess whether stone formation before pregnancy was associated with metabolic and hypertensive complications in pregnancy. We hypothesized that stone formation is a marker of metabolic disease and would be associated with higher risk for maternal complications in pregnancy. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective cohort study of women who delivered infants at the Massachusetts General Hospital from 2006 to 2015...
February 22, 2018: Clinical Journal of the American Society of Nephrology: CJASN
Bo Åkerström, Lena Rosenlöf, Anneli Hägerwall, Sigurbjörg Rutardottir, Jonas Ahlstedt, Maria E Johansson, Lena Erlandsson, Maria Allhorn, Magnus G Gram
AIMS: Human A1M (α1-microglobulin) is an endogenous reductase and radical- and heme-binding protein with physiological antioxidant protective functions. Recombinant human A1M (rA1M) has been shown to have therapeutic properties in animal models of preeclampsia, a pregnancy disease associated with oxidative stress. Recombinant A1M, however, lacks glycosylation, and shows lower solubility and stability than A1M purified from human plasma. The aims of this work was to 1) use site-directed mutagenesis to improve the physicochemical properties of rA1M, 2) demonstrate that the physicochemically improved rA1M displays full in vitro cell protective effects as recombinant wild-type A1M (rA1M-wt), and 3) show its therapeutic potential in vivo against acute kidney injury (AKI), another disease associated with oxidative stress...
February 22, 2018: Antioxidants & Redox Signaling
Hélène Collinot, Carmen Marchiol, Isabelle Lagoutte, Franck Lager, Nathalie Siauve, Gwennhael Autret, Daniel Balvay, Gilles Renault, Laurent J Salomon, Daniel Vaiman
BACKGROUND: Preeclampsia is a major hypertensive disease caused by pregnancy, inducing proteinuria and increased blood pressure starting from the second half of pregnancy (early preeclampsia) or near the end of pregnancy (late preeclampsia). Pre-symptomatic diagnosis would allow for therapeutic interventions, such as with low-dose aspirin. Among non-invasive methods to explore organ physiology, Doppler ultrasonography (US) and functional blood oxygenation level-dependent (BOLD) MRI (which do not need radioactive contrast agents such as gadolinium) can be used in pregnant women...
February 20, 2018: Journal of Hypertension
Yuehong Li, Wei Wang, Yujuan Wang, Qi Chen
BACKGROUND Analysis the maternal and fetal risk predictors in pregnancy in conjunction with chronic glomerulonephritis (CGN) patients are helpful to understand the influence of kidney diseases on pregnancy and the effects of pregnancy on kidney diseases. The aim of this study was to determine the predictors of adverse maternal and fetal outcomes in CGN patients. MATERIAL AND METHODS Maternal and fetal outcomes in 64 pregnancies of CGN patients were retrospectively analyzed. We randomly selected 100 low-risk-pregnancy women without chronic kidney disease (CKD) at the same time as the control group...
February 18, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Qian Ru Gu, Yang Yang Li, Guo Rong Chen, M J Quinn
In 1937, Drs. Moritz and Oldt described arteriolar injuries in the kidneys (and other viscera) in hypertension, across the age range, in both sexes, and, in different races. This hypothesis proposes that injuries to vasomotor nerves cause the arteriolar injury in the kidney in hypertension, (as well as that in the uterus in preeclampsia). Different patterns of perivascular hyalinisation in different viscera are clues to the varying causes and consequences of arteriolar injury. In the uterus there is a symmetrical, perivascular "halo of hyalinisation" that marks the lines of extension of regenerating, injured nerves to the placental bed, whereas in the kidney there is a disordered and asymmetrical "halo of hyalinisation" where persistent, and recurrent, increases in intravascular pressures interrupt development of regenerating nerves...
February 2018: Medical Hypotheses
William R Cooke, Ulla K Hemmilä, Alison L Craik, Chimwemwe J Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Rhys Evans
BACKGROUND: Obstetric-related acute kidney injury (AKI) is thought to be a key contributor to the overall burden of AKI in low resource settings, causing significant and preventable morbidity and mortality. However, epidemiological data to corroborate these hypotheses is sparse. This prospective observational study aims to determine the incidence, aetiology and maternal-fetal outcomes of obstetric-related AKI in Malawi. METHODS: Women greater than 20 weeks gestation or less than 6 weeks postpartum admitted to obstetric wards at a tertiary hospital in Blantyre, Malawi, and at high-risk of AKI were recruited between 21st September and 11th December 2015...
February 2, 2018: BMC Nephrology
Alejandro Treviño-Becerra
This review brings together concepts of uric acid metabolism affecting renal parenchyma and its function and the current therapies to reduce hyperuricemia (HyU) and avoid renal disease progression. High uric acid plays an important role in several chronic diseases including kidney diseases such as lithiasis, gout nephropathy, and preeclampsia. In the last 30 years, it has been shown that reducing HyU with low protein and low purine diets in addition to allopurinol creates physiopathological conditions that produce a slight increase in the glomerular filtration rate (GFR)...
2018: Contributions to Nephrology
Orli Silverberg, Alison L Park, Eyal Cohen, Deshayne B Fell, Joel G Ray
Importance: Women with an infant with preterm birth (PTB) or who was severely small for gestational age (SGA) are at higher future risk of premature cardiovascular disease and related death. Objective: To determine the risk of cardiac disease or death among women with an infant with both PTB and SGA. Design, Setting, and Participants: This population-based cohort study used electronic health records from the province of Ontario, Canada, where health care is universally available, between April 1, 2002, and March 31, 2016...
January 31, 2018: JAMA Cardiology
Linda M O'Keeffe, Anna Ramond, Clare Oliver-Williams, Peter Willeit, Ellie Paige, Patrick Trotter, Jonathan Evans, Jonas Wadström, Michael Nicholson, Dave Collett, Emanuele Di Angelantonio
Background: Long-term health risks for adults who donate kidneys are unclear. Purpose: To summarize evidence about mid- and long-term health risks associated with living kidney donation in adults. Data Sources: PubMed, Embase, Scopus, and PsycINFO without language restriction from April 1964 to July 2017. Study Selection: Observational studies with at least 1 year of follow-up that compared health outcomes in adult living kidney donors versus nondonor populations...
January 30, 2018: Annals of Internal Medicine
Sabrina M Scroggins, Donna A Santillan, Jenna M Lund, Jeremy A Sandgren, Lindsay K Krotz, Wendy S Hamilton, Eric J Devor, Heather A Davis, Gary L Pierce, Katherine N Gibson-Corley, Curt D Sigmund, Justin L Grobe, Mark K Santillan
The pathogenesis of preeclampsia, a hypertensive disorder of pregnancy, involves imbalanced T helper (TH) cell populations and resultant changes in pro- and anti-inflammatory cytokine release. Elevated copeptin (an inert biomarker of arginine vasopressin (AVP)), secretion precedes the development of symptoms in preeclampsia in humans, and infusion of AVP proximal to and throughout gestation is sufficient to initiate cardiovascular and renal phenotypes of preeclampsia in wild-type C57BL/6J mice. We hypothesize that AVP infusion in wild-type mice is sufficient to induce the immune changes observed in human preeclampsia...
January 25, 2018: Clinical Science (1979-)
Marco van Londen, Anouk W M A Schaeffers, Martin H de Borst, Jaap A Joles, Gerjan Navis, A Titia Lely
Maintenance of adequate renal function after living kidney donation is important for donor outcome. Overweight donors in particular may have an increased risk for end stage kidney disease (ESKD), and young female donors have an increased preeclampsia risk. Both of these risks may associate with low post-donation renal functional reserve (RFR). Because we previously found that higher BMI and lower post-donation RFR were associated, we now studied the relationship between BMI and RFR in young female donors. RFR, the rise in GFR (125I-Iothalamate clearance) during dopamine, was measured in female donors (<45 years) before and after kidney donation...
January 3, 2018: American Journal of Physiology. Renal Physiology
Rhys D R Evans, William Cooke, Ulla Hemmila, Viviane Calice-Silva, Jochen Raimann, Alison Craik, Chimwemwe Mandula, Priscilla Mvula, Ausbert Msusa, Gavin Dreyer, Nathan W Levin, Roberto Pecoits-Filho
Introduction: Obstetric-related acute kidney injury (AKI) is associated with adverse outcomes for mother and fetus, particularly in low-income countries. However, laboratory-independent tools to facilitate diagnosis are lacking. We assessed the diagnostic performance of a salivary urea nitrogen (SUN) dipstick to detect obstetric-related acute kidney disease in Malawi. Methods: Women at high risk for AKI admitted to an obstetric unit in Blantyre, Malawi, were recruited between 21 September and 11 December 2015...
January 2018: KI Reports
Salim Baghli, Catherine Abendroth, Umar Farooq, Jennifer A Schaub
The cause of acute kidney injury during pregnancy and in the postpartum period can be particularly challenging to diagnose, especially when it is necessary to differentiate among preeclampsia; eclampsia; hemolysis, elevated liver enzymes and low platelets (HELLP) syndrome; and thrombotic microangiopathies (TMAs). All these disease entities can present with kidney failure, microangiopathic hemolytic anemia, and thrombocytopenia. We present a teaching case of atypical hemolytic uremic syndrome in the postpartum period in a young woman who was found to have mutations of uncertain clinical significance in the complement cascade, including in C3, CFH, and CFI...
January 10, 2018: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Rugina Neuman, A H Jan Danser
Agonistic autoantibodies (AAs) directed against receptors of the sympathetic nervous system and the renin-angiotensin system have been suggested to contribute to cardiovascular and renal disease, in particular hypertension, preeclampsia, and graft failure in kidney transplantation patients. Consequently, they are now also being studied as biomarker for these conditions. This commentary summarizes our current understanding of these AAs, critically discussing whether they truly act as agonist, and focusing on the wide array of assays that are currently used for their quantification...
January 16, 2018: Clinical Science (1979-)
Yin Zhao, YanFang Zheng, XiaoXia Liu, QingQing Luo, Di Wu, XiaoPing Liu, Li Zou
STUDY QUESTION: Is it possible to improve vascular remodeling by inhibiting the excessive expression of protease activated receptor 1 (PAR-1) in trophoblast of abnormal placenta? SUMMARY ANSWER: Inhibition of trophoblast PAR-1 overexpression may promote placental angiogenesis and vascular remodeling, offering an alternative therapeutic approach for preeclampsia. WHAT IS KNOWN ALREADY: PAR-1 is high-affinity receptor of thrombin. Thrombin increases sFlt-1 secretion in trophoblast via the activation of PAR-1...
January 9, 2018: Molecular Human Reproduction
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
Alyssa Kahane, Alison L Park, Joel G Ray
BACKGROUND: There exist structural and physiological commonalities between myometrial and myocardial tissue, and each can become dysfunctional, such as in the presence of cardiometabolic factors. METHODS: This population-based cohort study was comprised of 1,608,720 women with ≥ 1 singleton hospital live birth at 24-41 weeks' gestation in Ontario, from 1992 to 2016. The main exposure was prolonged first stage of labour; secondary exposure was prolonged second stage of labour...
January 2018: Canadian Journal of Cardiology
J A Tamblyn, C Jenkinson, D P Larner, M Hewison, M D Kilby
Vitamin D deficiency is common in pregnant women and may contribute to adverse events in pregnancy such as preeclampsia (PET). To date, studies of vitamin D and PET have focused primarily on serum concentrations vitamin D, 25-hydroxyvitamin D3 (25(OH)D3) later in pregnancy. The aim here was to determine whether a more comprehensive analysis of vitamin D metabolites earlier in pregnancy could provide predictors of PET. Using samples from the SCOPE pregnancy cohort, multiple vitamin D metabolites were quantified by liquid chromatography-tandem mass spectrometry in paired serum and urine prior to the onset of PET symptoms...
January 2018: Endocrine Connections
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