Abstract
Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria. Damage of podocyte cells has been reported in pre-eclamptic women, thus podocyte specific proteins such as nephrin and podocalyxin could be useful biomarkers in PE. To investigate the role of urinary nephrin (u-nephrin) and urinary podocalyxin (u-PDX) levels in predicting PE in women with a high-risk pregnancy. We included 101 pregnant women in this study and allocated them into three groups: group 1 included pregnant women at high risk of developing PE (n=41), group 2 - pregnant women with PE (n=30), and group 3 was the controls including healthy pregnant women (n=30). The inclusion criteria for women with PE were de novo hypertension >140/90 mm Hg, proteinuria >300 mg/24 hours, and presence of edema after 20 weeks of gestation, while the exclusion criteria were a history of renal diseases and pregnant women younger than 18. Inclusion criteria for the group of women with a high-risk pregnancy was gestational week >15, a history of PE in a previous pregnancy, pre-existing diabetes type 1 or 2, pre-existing hypertension, multiple gestations, prior placental abruption, obesity women, nulliparity, maternal age >35 years, and a family history of PE. The study was conducted from March 2016 to May 2017 in the Medical Faculty at the Institute of Medical and Experimental Biochemistry in Skopje. Urine samples were used to measure the nephrin and podocalyxin levels using immunoenzyme assay, creatinine and microalbumin. Blood samples were collected for biochemical analyses. U-nephrin levels were elevated in 96.7% of women with PE, and 73% of women with a high-risk pregnancy. U-PDX levels were elevated in 63% of the women with PE and 100% of the women with a high-risk pregnancy. U-nephrin and u-PDX levels were significantly increased in women with a high-risk pregnancy and women with PE compared with a control group (p.
Highlights
Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria
receiver operative characteristic (ROC) analysis revealed that the cut-off value of 304.6 ng/ ml of u-nephrin had a sensitivity (Se) of 96.7%, specificity (Sp) of 96.7% (for both Se and Sp 95% confidence interval (CI) 82.8-99.9), while the cut-off value of 59.5 ng/ml of urinary podocalyxin (u-PDX) had a sensitivity of 100% and Sp of 93.3% (Se - 95% CI 88.4-100, Sp - 95% CI 77.9-99.2), in distinguishing women with PE and healthy pregnancies
The level of u-PDX was statistically significantly elevated in groups of women with PE and women with a high-risk pregnancy compared to healthy subjects (p
Summary
Pre-eclampsia (PE) is characterized by new-onset hypertension and proteinuria. Damage of podocyte cells has been reported in pre-eclamptic women, podocyte specific proteins such as nephrin and podocalyxin could be useful biomarkers in PE. Pre-eclampsia affects 2–8% of pregnancies, overall, 10-15% of all direct maternal deaths are associated with PE in low and middle-income countries.[1,2,3] In the past decade, the incidence of PE has increased as a result of the increased prevalence of predisposing factors, namely maternal age, chronic hypertension, PE in a previous pregnancy or a family history of PE, diabetes, pre-pregnancy obesity, and multiple gestations.[4] PE is defined as the presence of systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg on two occasions at least 4 hours apart in previously normotensive women, and is accompanied by one or more of the following new‐onset conditions at or after 20 weeks of gestation: 1. Uteroplacental dysfunction (such as intrauterine growth restriction, abnormal umbilical artery Doppler waveform analysis, or stillbirth).[5]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
