Endothelial and kidney function in women with a history of preeclampsia and healthy parous controls: A case control study

Preeclampsia (PE) is a pregnancy related endothelial disease characterized by hypertension and albuminuria. Postpartum endothelial dysfunction often persists in these women. We postulate that in women with a history of PE reduced endothelial dependent vasodilation coincides with attenuated kidney fu...

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Bibliographic Details
Published in:Microvascular research 2018-03, Vol.116, p.71-76
Main Authors: Lopes van Balen, Veronica A., Spaan, Julia J., Cornelis, Tom, Heidema, Wieteke M., Scholten, Ralph R., Spaanderman, Marc E.A.
Format: Article
Language:English
Subjects:
Adult
Albuminuria - physiopathology
Albuminuria - urine
Biomarkers - urine
Brachial Artery - diagnostic imaging
Brachial Artery - physiopathology
Case-Control Studies
Creatinine - urine
Cross-Sectional Studies
Endothelium, Vascular - diagnostic imaging
Endothelium, Vascular - physiopathology
Female
Glomerular Filtration Rate
Humans
Kidney - physiopathology
Parity
Pre-Eclampsia - diagnosis
Pre-Eclampsia - physiopathology
Pregnancy
Time Factors
Ultrasonography, Doppler
Vasodilation
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Summary:Preeclampsia (PE) is a pregnancy related endothelial disease characterized by hypertension and albuminuria. Postpartum endothelial dysfunction often persists in these women. We postulate that in women with a history of PE reduced endothelial dependent vasodilation coincides with attenuated kidney function, as both reflect endothelial dysfunction. We assessed endothelial and kidney function in women with a history of PE (n=79) and uncomplicated pregnancies (n=49) at least 4years postpartum. Women with hypertension, diabetes or kidney disease prior to pregnancy were excluded. Brachial artery flow mediated dilatation (FMD) was measured and analysed by a custom designed edge-detection and wall-tracking software. We measured albumin and creatinine levels in a 24-h urine sample and calculated glomerular filtration rate (GFR) by CKD-EPI. Women with a history of PE had lower FMD but comparable GFR and albumin creatinine ratio (ACR) compared with controls. Independent of obstetric history, in both controls and women with a history of PE respectively, GFR (r=0.19, p=0.17 and r=0.12, p=0.29) and albumin creatinine ratio (r=0.07, p=0.62 and r=0.06 p=0.57) did not correlate with FMD. At least 4years after pregnancy, women with a history of PE demonstrated decreased flow mediated dilatation when compared to healthy parous controls. In this study, decreased flow mediated dilation however did not coincide with decreased kidney function. •Women with a history of preeclampsia have decreased FMD when compared to healthy parous controls, suggesting endothelial dysfunction.•Women with a history of preeclampsia have similar GFR and urinary albumin loss when compared to healthy parous controls.•We observed no correlation between FMD and kidney function.•Even though decreased FMD and microalbuminuria both reflect endothelial dysfunction they may reflect different aspects of endothelial function or recover at a different rate.
ISSN:0026-2862
1095-9319
DOI:10.1016/j.mvr.2017.11.001