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preeclampsia and kidney

Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
David G Reuter, Yuk Law, Wayne C Levy, Stephen P Seslar, R Eugene Zierler, Mark Ferguson, James Chattra, Tim McQuinn, Lenna L Liu, Mark Terry, Patricia S Coffey, Jane A Dimer, Coral Hanevold, Joseph T Flynn, F Bruder Stapleton
The morbidity and mortality associated with preeclampsia is staggering. The physiology of the Page kidney, a condition in which increased intrarenal pressure causes hypertension, appears to provide a unifying framework to explain the complex pathophysiology. Page kidney hypertension is renin-mediated acutely and ischemia-mediated chronically. Renal venous outflow obstruction also causes a Page kidney phenomenon, providing a hypothesis for the increased vulnerability of a subset of women who have what we are hypothesizing is a "renal compartment syndrome" due to inadequate ipsilateral collateral renal venous circulation consistent with well-known variation in normal venous anatomy...
September 15, 2016: Journal of the American Society of Hypertension: JASH
Eun Hui Bae, Jong Woon Kim, Hong Sang Choi, Seong Kwon Ma, Soo Wan Kim
Background/Aims: Proteinuria is associated with hypertension and preeclampsia in pregnancy. However, the impact of random urine proteinuria on fetal and maternal outcomes has not been established. We investigated the influence of random urine proteinuria on the clinical outcomes of pregnancy. Methods: From January 2008 to December 2010, 2,822 patients were retrospectively studied. A total of 536 pregnant women with proteinuria in random urine and matched controls without proteinuria via propensity score matching were analyzed...
October 13, 2016: Korean Journal of Internal Medicine
Andrea G Kattah, Dawn C Scantlebury, Sanket Agarwal, Michelle M Mielke, Walter A Rocca, Amy L Weaver, Lisa E Vaughan, Virginia M Miller, Tracey L Weissgerber, Wendy White, Vesna D Garovic
BACKGROUND: Several registry-based studies, using diagnostic codes, have suggested that preeclampsia is a risk factor for end-stage renal disease (ESRD). However, because the 2 diseases share risk factors, the true nature of their association remains uncertain. Our goals were to conduct a population-based study to determine the magnitude of the association between preeclampsia and ESRD and evaluate the role of shared risk factors. STUDY DESIGN: Population-based nested case-control study...
October 1, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
Biljana Gerasimovska Kitanovska, Vesna Gerasimovska, Vesna Livrinova
BACKGROUND: Alport syndrome is a genetic disease that progresses to chronic kidney failure, with X-linked, autosomal dominant or autosomal recessive type of inheritance. Women are generally carriers of the mutation and have a milder form of the disease. During pregnancy, they have an increased risk of impaired kidney function and preeclampsia. CASE PRESENTATION: A 27-year old woman, gravida 1, para 0, in her 23rd gestational week came to the outpatient unit of the University Clinic of Nephrology for the first time because of slowly progressing proteinuria and Alport syndrome...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Sammya Bezerra Maia E Holanda Moura, Paulo Cesar Praciano, Julio Augusto Gurgel Alves, Wellington P Martins, Edward Araujo, Stefan C Kane, Fabrício da Silva Costa
OBJECTIVE: To examine whether the maternal renal interlobar vein impedance index (RIVI) as assessed by first trimester ultrasonography is able to predict the later development of hypertensive disorders of pregnancy. METHODS: Venous Doppler parameters of both maternal kidneys were studied in 214 pregnant women at 11 + 0 to 13 + 6 weeks' gestation. Subjects were classified according to the outcomes related to hypertensive disorders. Detection rates and areas under receiver operating characteristic (ROC) curves were determined for the maternal RIVI impedance as a first trimester predictor for preeclampsia (PE) and gestational hypertension (GH)...
August 2016: Journal of Maternal-fetal & Neonatal Medicine
Monika Chaszczewska-Markowska, Maria Sagan, Katarzyna Bogunia-Kubik
Secretion of renin juxtaglomerular cells into bloodstream initiates activation of an enzymatic-hormonal cascade known as the RAAS (renin - angiotensin - aldosterone system). As a result, blood pressure is increased by the means several interrelated mechanisms. Mechanism of Zjednoczoaction of this system has been known for decades, but a few previously unknown components were recently added, such as ACE-2 and Ang(1-7), and their role often seems to be opposite to that of the conventional components. Local tissue systems also have important biological functions...
September 13, 2016: Postȩpy Higieny i Medycyny Doświadczalnej
Anouk Bokslag, Mirjam van Weissenbruch, Ben Willem Mol, Christianne J M de Groot
Preeclampsia is a common pregnancy specific disease, that presents with hypertension and a variety of organ failures, including malfunction of kidneys, liver and lungs. At present, the only definitive treatment of preeclampsia is end the pregnancy and deliver the neonate and placenta. For women with mild preeclampsia in the preterm phase of pregnancy, expectant management is generally indicated to improve fetal maturity, often requiring maternal medical treatment. Last decades, more evidence is available that the underlying mechanism of preeclampsia, endothelial disease, is not limited to pregnancy but increases cardiovascular risk in later life...
September 19, 2016: Early Human Development
Suzanne Oparil
Heart disease, stroke, and kidney failure are leading causes of death worldwide, and hypertension is a significant risk factor for each. Hypertension is less common in women, compared to men, in those younger than 45 years of age. This trend is reversed in those 65 years and older. In the US between 2011-2014, the prevalence of hypertension in women and men by age group was 6% vs 8% (18-39 years), 30% vs 35% (40-59 years), and 67% vs 63% (60 years and over). Awareness, treatment, and control rates differ between genders with women being more aware of their diagnosis (85% vs 80%), more likely to take their medications (81% vs 71%) and more frequently having controlled hypertension (55% vs 49%)...
September 2016: Journal of Hypertension
Krista L Lentine, Dorry L Segev
Communicating the current knowledge of medical outcomes after live kidney donation necessary to support donor candidates in well informed decision-making requires grounding in perspectives of comparison. Baseline risk (without donating), risk attributable to donation, and absolute risk (after donating) need to be considered. Severe perioperative complications and death are rare, but vary by demographic, clinical, and procedure factors. Innovative capture of "healthy" controls designed to simulate donor selection processes has identified higher risk of ESRD attributable to donation in two studies; importantly, however, the absolute 15-year ESRD incidence in donors remains very low (0...
September 2, 2016: Journal of the American Society of Nephrology: JASN
Jean F Regal, Megan E Strehlke, Jenna M Peterson, Cameron R Wing, Jordan E Parker, Noel Fernando Nieto, Lynne T Bemis, Jeffrey S Gilbert, Sherry D Fleming
Preeclampsia is characterized by development of hypertension during pregnancy and reduced placental perfusion. Previous studies in a rat model of placental ischemia-induced hypertension demonstrated that inhibiting complement activation attenuated increased maternal blood pressure with C3a and C5a identified as the important products of complement activation. Given that in other forms of ischemia both natural IgM and antigen antibody complexes initiate complement activation, we hypothesized that placental ischemia exposes neoepitopes recognized by IgM to cause local complement activation and hypertension...
October 2016: Molecular Immunology
Raafat Makary, Amir Mohammadi, Marilin Rosa, Sania Shuja
Complete hydatidiform (also referred to as hydatiform) mole with coexisting live fetus is an exceedingly rare event. The fetus usually has a normal karyotype, and approximately 25-40% chance of survival, if pregnancy is allowed to continue until reasonable fetal lung maturity is achieved. However, risk of maternal complications including preeclampsia and subsequent trophoblastic disease are significant. We report a case of a 19-year-old primigravida, at 25 weeks gestation with a complete hydatidiform mole and a coexisting live fetus...
March 2010: Obstetric Medicine
Said Azzoug, Farida Chentli
Diabetic microangiopathy is a frequent complication of longstanding diabetes mellitus. Micro vascular lesions may have severe implications for both maternal and foetal health. Patients with advanced underlying lesions are at increased risk of progression during pregnancy. Severe retinal lesions can progress during pregnancy and one year after delivery. Poor glycaemic control prior to conception and rapid improvement during pregnancy are other risk factors of progression. Treatment of lesions with high risk of progression and progressive blood glucose lowering in the preconception period can improve the prognosis...
September 2016: JPMA. the Journal of the Pakistan Medical Association
Yamile Lopez-Hernandez, Jorge Alejandro Saldivar-Nava, Idalia Garza-Veloz, Ivan Delgado-Enciso, Laura Elia Martinez-de-Villarreal, Patricia Yahuaca-Mendoza, Iram Pablo Rodriguez-Sanchez, Laura Lopez-Gilibets, Jorge Issac Galvan-Tejada, Carlos Eric Galvan-Tejada, Jose Maria Celaya-Padilla, Margarita L Martinez-Fierro
PURPOSE: The aim of this study was to evaluate the usefulness of urine concentrations of 12 proteins as a risk parameter for developing preeclampsia (PE). METHODS: A nested case-control study was designed to determine protein concentrations in urine from women predicted to develop PE (WPD-PE) and normotensive pregnancies (controls). Protein profiles were determined at 12, 16 and 20 gestational weeks (GW) using the Bio-Plex Pro human kidney toxicity Panel 1 and Panel 2 (Bio-Rad)...
August 29, 2016: International Urology and Nephrology
T Kaleta, A Stock, D Panayotopoulos, O Vonend, D Niederacher, M Neumann, T Fehm, W Kaisers, M Fleisch
Objective. The purpose of this prospective study was to investigate the predictive value of single prepartum findings combined with serum biomarkers sFlt-1 (soluble fms-like tyrosine kinase-1) and PlGF (placental growth factor) indicating severity of preeclampsia (PE) for occurrence and extent of impaired postpartum kidney function. Study Design. In this prospective, single center study 44 PE patients were compared to 39 healthy controls (similar in age and gestational age with singleton pregnancy) evaluated at time of delivery and at 6 months and 12 months postpartum...
2016: Disease Markers
Florent Seguro, Béatrice Duly Bouhanick, Bernard Chamontin, Jacques Amar
In the first 6 months of pregnancy, the primary goal of antihypertensive treatment is to prevent the complications of severe hypertension. Initiation of antihypertensive drug treatment is recommended in pregnant women with severe hypertension (blood pressure>160/110mmHg). Initiation of antihypertensive drug treatment should also be considered in pregnant women at high cardiovascular risk (diabetes, chronic kidney disease, personal history of cardiovascular disease) with moderate hypertension (blood pressure between 140-159/90-109mmHg)...
July 2016: La Presse Médicale
Juhi Bharti, Richa Vatsa, Seema Singhal, Kallol Kumar Roy, Sunesh Kumar, Vanamail Perumal, Jyoti Meena
OBJECTIVE: Pregnancy with chronic kidney disease (CKD) is considered to be high risk. The purpose of this study was to assess the effect of pregnancy on CKD and the fetomaternal outcome in these patients. STUDY DESIGN: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology, All India Institute of medical sciences, New Delhi over a period of 11 years. A total number of 80 pregnant patients with CKD were reviewed. Staging of CKD was done according to glomerular filtration rate (GFR)...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Arthur J Matas, Rebecca E Hays, Hassan N Ibrahim
Despite generally positive outcomes and high rates of satisfaction, living kidney donors are at risk for both medical and psychosocial problems. This review summarizes non-ESRD risks for donors, and describes limitations to the data. We review evidence of medical risks (e.g., increased cardiovascular disease and mortality, preeclampsia) and psychosocial risks (e.g., mood disturbance, financial burden). We discuss evidence of differential risks among subsets, and the impact of postdonation events (e.g., development of diabetes)...
August 16, 2016: American Journal of Transplantation
Natalie L Davidson, Penny Wolski, Leonie K Callaway, Helen L Barrett, Narelle Fagermo, Karin Lust, Rebekah E Shakhovskoy
BACKGROUND: There is a paucity of Australian data regarding renal disease in pregnancy. We undertook a retrospective cohort study at a tertiary institution to examine the impact of renal disease on pregnancy outcomes and the effect of pregnancy on disease progression. METHODS: A total of 55 pregnancies of patients with renal disease admitted from 2003 to 2010 to the Royal Brisbane and Women's Hospital were analysed. Pre-conception variables, fetal/delivery and maternal outcomes were analysed in this group and in a control group of women with normal kidney function pre-pregnancy...
June 2015: Obstetric Medicine
J Prakash, P Pant, S Prakash, M Sivasankar, R Vohra, P K Doley, L K Pandey, U Singh
The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10...
July 2016: Indian Journal of Nephrology
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