Preeclampsia and Prevalence of Microalbuminuria 10 Years Later

Sandvik, Miriam Kristine; Hallan, Stein; Svarstad, Einar; Vikse, Bjørn Egil

doi:10.2215/cjn.10641012

Cited by 45 publications

(38 citation statements)

References 37 publications

(39 reference statements)

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“…These figures were similar to those seen by whose median ages were 27 years for microalbuminuria group and 28 years for non-microalbuminuria group [26]. On the other hand, our study population were much younger than those seen by Sandvik et al whose patients' mean age was 37.9 years among cases with preeclampsia and 39 years among cases without preeclampsia [27].…”

Section: Discussionsupporting

confidence: 89%

“…The mean blood pressure at booking was 118.5/75 mm Hg for high risk group and 117/75.2 mm Hg for low risk group. Sandvik et al found a slight and non-significant difference between cases with preeclampsia and those with non-preeclampsia [27]. Blood pressure rose at delivery by around 6-9 mm Hg to be 127.2/80.8 mm Hg for high risk group and 124.2/81.2 mm Hg for low risk group.…”

Section: Discussionmentioning

confidence: 97%

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Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia

2017

JFIV Reprod Med Genet

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Patients and methods: This study was done on 110 pregnant women attended the department of Obestatric and Gynecology, Sayed Galal University Hospital in the period from 4/2014 to 5/2015. From those 110 cases, 4 did not accept to be included in the study and another 6 cases were excluded due to history of significant liver disease, leaving one hundred cases to be included in the study. The laboratory investigations were done for all of the 100 cases in the department of Clinical Pathology, Sayed Galal University Hospital.Results: Although microalbuminuria were more frequently seen among high risk group, the difference was nonsignificant. The cause may be the limited number of cases in the two groups. The mean age of cases was slightly higher than controls, but with a non-significant difference.Taking into consideration that primigravida per se is a risk factor for preeclampsia, all of the 21 primigravida cases were considered as high risk. All of the low risk groups were in the full term, with three cases of the high risk group were preterm. The mean gestational age of the two groups showed non-significant difference. The mean blood pressure both at booking and at delivery showed non-significant differences between the cases and the control subjects. We found a mild rise of blood pressure by around 6-9 mm Hg. The difference between the blood pressure at booking and at delivery was highly significant, which means that this rise was seen in nearly all cases and controls. Slightly higher than one quarter of cases and control group delivered by CS, with the remaining delivered by normal vaginal delivery. There is no significant difference between the two groups as regards the mode of delivery. Birth weight was slightly lower in the cases group than in the control group, with a non-significant difference. The 24 h protein in urine was higher in the cases group than in the control group by around 35 mg. However, the difference between the two groups was non-significant. The non-significance here may be due to the high standard deviation in both groups. PIH was seen only in 7 subjects; 3 in the cases group and 4 in the control group, with a non-significant difference between the two groups. Preeclampsia was seen in 6 cases (12%) of the cases group, compared to 4 cases (8%) of the control groups. This difference was non-significant both because of the low difference between the two groups (only 2 cases) and the limited number of positive cases in both groups. No cases of eclampsia were diagnosed in our study patients or controls. Although age was directly related with the albuminuria, with maximum age among patients with macroalbuminuria and minimum age among patients with no albuminuria; the difference was non-significant. There was non-significant relation between parity and the albuminuria. The cause of this non significance is due to the limited number of micro and macro-albuminuria in our study groups. Blood pressure showed a steady increase between the normal and microalbuminuria and between micro and macro...

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 97%

Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia

2017

JFIV Reprod Med Genet

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“…However, in a recent large Norwegian study (22), PE was not associated with microalbuminuria. In line with the results from Sandvik et al (22), a morning urine sample collected after completion of our study did not show a difference in albuminuria between the groups; all women had albuminuria values within the normal range.…”

Section: Discussionmentioning

confidence: 76%

Higher filtration fraction in formerly early-onset preeclamptic women without comorbidity

Toering

Graaf

Visser

et al. 2015

American Journal of Physiology-Renal Physiology

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Formerly preeclamptic women have an increased risk for developing end-stage renal disease, which has been attributed to altered renal hemodynamics and abnormalities in the renin-angiotensin-aldosterone system. Whether this is due to preeclampsia itself or to comorbid conditions is unknown. Renal hemodynamics and responsiveness to ANG II during low Na ϩ intake (7 days, 50 mmol Na ϩ /24 h) and high Na ϩ (HS) intake (7 days, 200 mmol Na ϩ /24 h) were studied in 18 healthy normotensive formerly early-onset preeclamptic women (fPE women) and 18 healthy control subjects (fHP women), all selected for absence of comorbidity. At the end of each diet, renal hemodynamics and blood pressure were measured before and during graded ANG II infusion. Both HS intake and former preeclampsia increased filtration fraction (FF) without an interaction between the two. FF was highest during HS intake in fPE women [0.31 Ϯ 0.12 vs. 0.29 Ϯ 0.11 in fHP women, generalized estimating equation analysis (body mass index corrected), P ϭ 0.03]. The renal response to ANG II infusion was not different between groups. In conclusion, fPE women have a higher FF compared with fHP women. As this was observed in the absence of comorbidity, preeclampsia itself might exert long-term effects on renal hemodynamics. However, we cannot exclude the presence of prepregnancy alterations in renal function, which, in itself, lead to an increased risk for preeclampsia. In experimental studies, an elevated FF has been shown to play a pathogenic role in the development of hypertension and renal damage. Future studies, however, should evaluate whether the subtle differences in renal hemodynamics after preeclampsia contribute to the increased long-term renal risk after preeclampsia. preeclampsia; postpartum; renal hemodynamics; renin-angiotensinaldosterone system; Na ϩ intake COMPLICATING up to 8% of pregnancies, preeclampsia (PE) is a major cause of maternal and fetal morbidity and mortality worldwide (27). PE is characterized by the de novo development of hypertension and proteinuria during the second half of pregnancy. Although it is a pregnancy-specific disease, evidence has mounted that PE has important long-term implications for maternal health, in particular, cardiovascular and renal health (2,24,33). It is, however, uncertain whether the increased renal and cardiovascular risk in formerly preeclamptic women is explained by PE itself or by underlying common (prepregnant) risk factors and comorbidity. Recent data have shown that formerly preeclamptic women have a 5-to 14-fold higher risk for developing end-stage renal disease (ESRD) (33, 36). Moreover, women who experienced multiple preeclamptic pregnancies have an even higher risk for ESRD (33). The risk for developing cardiovascular disease is especially high for women who have a history of early-onset PE (before 34 wk of gestational age) (2). It is unknown whether this also applies for the risk of developing ESRD. However, in a large Norwegian cohort study, the association between former PE and developing ESRD...

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“…6 The study by Mangos et al 7 reported no differences in eGFR after preeclampsia, but Spaan et al 8 found a lower renal function shortly after preeclampsia and at middle age. In contrast, a study at 10 years postpartum by Sandvik et al 9 shows a high-normal eGFR in former preterm preeclamptic women. In addition, we recently reported a slightly higher renal filtration fraction 10 years postpartum by radioactive tracer measurement in a well-controlled small cohort after early-onset PE.…”

mentioning

confidence: 84%

“…However, some studies that were not included in the meta-analysis report the incidence of proteinuria in fPE being low and similar to that of fHP women. 7,9,11 The conflicting results of the different studies on renal function and albuminuria after preeclampsia might be because of small-sized studies and heterogeneity within the fPE group, including a case-mix of early and late preeclampsia. We, therefore, aimed to study renal function in a large cohort at 10 years postpartum of well-characterized former early-onset PE women.…”

Section: Hypertensionmentioning

confidence: 99%

High-Normal Estimated Glomerular Filtration Rate in Early-Onset Preeclamptic Women 10 Years Postpartum

et al. 2016

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Abstract-Women with a history of preeclampsia have a 5-to 12-fold increased risk to develop end-stage kidney disease.Previous observations in small cohorts suggest that former preeclamptic (fPE) women have subtle abnormalities in renal hemodynamics and renal function, which might predispose them to renal failure in later life. In this study, we analyzed renal function in a cross-sectional cohort consisting of former early-onset preeclamptic (fPE, n=339) and former healthy pregnant women (fHP, n=332), overall with a mean age of 39 years at 10 years postpartum. Estimated glomerular filtration rate (eGFR), assessed by the modification of diet in renal disease (MDRD) and chronic kidney disease-epidemiology (CKD-epi) equations, and urinary protein:creatinine ratios were assessed 10 years postpartum. Median MDRD and CKD-epi eGFR did not significantly differ between fHP and fPE groups, whereas a comparison of distribution of eGFR revealed a shift toward a high-normal MDRD eGFR in the fPE group (χ 2 , P=0.02) with the same trend for CKD-epi eGFR (χ 2 , P=0.18). The odds ratio for fPE women having MDRD eGFR >110 mL/min per 1.73 m 2 was 1.6 (1.1-2.4). In addition, the median urinary protein:creatinine ratio was slightly higher in fPE (8.5 versus 7.1 mg/mmol; P<0.01) and correlated positively with both MDRD and CKD-epi eGFR in fPE women. No increased incidence of CKD in fPE women was observed.In conclusion, we demonstrate subtle changes in renal function in former early-onset preeclamptic women 10 years postpartum, characterized by a high-normal eGFR and a slightly higher protein excretion. Whether these subtle differences predispose to or predict long-term renal function loss in fPE women remains to be investigated. Clinical Trial Registration-URL: http://www.trialregister.nl. Unique identifier: NTR2668.

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Preeclampsia and Prevalence of Microalbuminuria 10 Years Later

Cited by 45 publications

References 37 publications

Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia

Early Pregnancy Microalbuminuria as a Predictor of Pre-Eclampsia

Higher filtration fraction in formerly early-onset preeclamptic women without comorbidity

High-Normal Estimated Glomerular Filtration Rate in Early-Onset Preeclamptic Women 10 Years Postpartum

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