Superimposed Preeclampsia Exacerbates Postpartum Renal Injury Despite Lack of Long-Term Blood Pressure Difference in the Dahl Salt-Sensitive Rat

Preeclampsia results in increased susceptibility to hypertension and chronic kidney disease postpartum; however, the mechanisms responsible for disease progression in these women remain unknown. The purpose of this study was to test the hypothesis that 2 mechanisms contribute to the link between the...

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Bibliographic Details
Published in:Hypertension (Dallas, Tex. 1979) Tex. 1979), 2019-03, Vol.73 (3), p.650-658
Main Authors: Turbeville, Hannah R, Taylor, Erin B, Garrett, Michael R, Didion, Sean P, Ryan, Michael J, Sasser, Jennifer M
Format: Article
Language:English
Subjects:
Animals
Biomarkers - metabolism
Blood Pressure - physiology
Cytokines - metabolism
Disease Models, Animal
Disease Progression
Female
Kidney - metabolism
Kidney - pathology
Postpartum Period
Pre-Eclampsia - chemically induced
Pre-Eclampsia - physiopathology
Pregnancy
Pregnancy, Animal
Rats
Rats, Inbred Dahl
Renal Insufficiency, Chronic - etiology
Renal Insufficiency, Chronic - metabolism
Renal Insufficiency, Chronic - physiopathology
Sodium Chloride, Dietary - toxicity
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Summary:Preeclampsia results in increased susceptibility to hypertension and chronic kidney disease postpartum; however, the mechanisms responsible for disease progression in these women remain unknown. The purpose of this study was to test the hypothesis that 2 mechanisms contribute to the link between the maternal syndrome of preeclampsia and the increased postpartum risk of cardiovascular and renal disease(1) increased T cells in the kidney and (2) a decreased NO:ET-1 (endothelin-1) ratio. Dahl S rats (a previously characterized model of preeclampsia superimposed on chronic hypertension) who experienced 2 pregnancies and virgin littermate controls were studied at 6 months of age. Mean arterial pressure was measured via telemetry, and renal injury was assessed through both histological analysis and measurement of urinary markers including nephrin, podocalyxin, and KIM-1 (kidney injury marker 1). Contributing mechanisms were assessed through flow cytometric analysis of renal T cells, quantification of plasma TNF-α (tumor necrosis factor-α) and IL-10 (interleukin-10), and quantification of urinary concentrations of NO metabolites and ET-1. Although prior pregnancy did not exacerbate the hypertension at 6 months, this group showed greater renal injury compared with virgin littermates. Flow cytometric analyses revealed an increase in renal T cells after pregnancy, and cytokine analysis revealed a systemic proinflammatory shift. Finally, the NO:ET-1 ratio was reduced. These results demonstrate that the link between the maternal syndrome of superimposed preeclampsia and postpartum risk of chronic kidney disease could involve both immune system activation and dysregulation of the NO:ET-1 balance.
ISSN:0194-911X
1524-4563
DOI:10.1161/HYPERTENSIONAHA.118.12097