The Kidney in Normal Pregnancy and Preeclampsia

Detection of Proteinuria in Pregnancy: Comparison of Qualitative Tests for Proteins and Dipsticks with Urinary Protein Creatinine Index

“…They had further observed that proteinuria was greater in the second half of the pregnancy, as compared to the first. This observation matches ours, and was interesting as maximal increases in glomerular filtration have already appeared before mid pregnancy, and GFR might actually decline near term [18]. These observations suggest that either filtration or tubular reabsorption of proteins may change in late gestation [9].…”

Unveiling the Vasodilatory Actions and Mechanisms of Relaxin

“…Consequently, both renal plasma flow (RPF) and glomerular filtration rate (GFR) increase by ~ 50% compared to nonpregnant levels (reviewed in [10, 17, 18]). Similar changes in renal function are observed in the luteal stage of the menstrual cycle (relative to the follicular phase), albeit of a lesser magnitude [10, 17, 18], when serum relaxin is detectable [1]. Comparable changes in the renal circulation are observed during pregnancy in chronically instrumented, conscious rats that peak during midterm gestation in this species [10, 18, 19].…”

“…Although a role for the other renal NOS isoforms cannot be excluded and requires further investigation, the possibility was explored that NOS, presumably endothelial NOS, might be activated by endothelin (ET), thereby mediating the NO-dependent renal vasodilatory changes during pregnancy or by relaxin administration [27, 44]. This hypothesis was based on previous studies that established a role for the endothelial ET B receptor in the maintenance of low renal vascular tone in the nonpregnant condition most likely by tonic stimulation of nitric oxide (reviewed in [17, 18, 45]). Thus, it was proposed that during pregnancy, relaxin accentuates this vasodilatory pathway in the renal circulation [27, 44].…”

GPCRs as potential therapeutic targets in preeclampsia

“…Preeclampsia - defined clinically by the presence of new onset hypertension and proteinuria after the 20 th week of gestation - is a potentially life-threatening pregnancy complication, accompanied by vascular abnormalities including endothelial dysfunction, systemic vasoconstriction and reduced organ perfusion, as well as activation of platelets and the coagulation cascade [11]. The origins of the condition are thought to lie in the placenta, wherein impaired uterine spiral artery modification during early pregnancy leads to inadequate perfusion, resulting in the release of factor(s) that may conspire with a susceptible maternal constitution (e.g., vulnerable endothelium) to cause clinical disease.…”