Urinary coagulation-fibrinolysis, kallirein-kinin systems and kininase in cases of preclampsia.
Urinary kallikrein and kallikrein activity significantly decreased in cases of preeclampsia (u-kall./CRE.index 42.39 +/- 9.66 ng/mg, u-kall. act./CRE.index 0.26 +/- 0.06 ng/min/mg), and urinary kininase II and kininase activity significantly increased (u-kininase/CRE.index 10.91 +/- 1.26 x 10(-3) IU/min/mg, u-kininase act./CRE.index 506.37 +/- 178.45 pg/min/mg) when compared with those of normal gravidas from 28 weeks to 42 weeks of gestation (u-kall./CRE.index 189.31 +/- 14.17 ng/mg, u-kall. act./CRE index 1.08 +/- 0.10 ng/min/mg, u-kininase/CRE.index 6.24 +/- 0.31 x 10(-3) IU/min/mg, u-kininase act./CRE.index 15.64 +/- 0.10 pg/min/mg). Urinary FPA, B beta 5-42, alpha 2-PI, and alpha 2PI-plasmin-complex (PIC) significantly increased in preeclampsia (u-FPA/CRE.index 23.59 +/- 8.47 ng/mg, u-B beta/CRE.index 105.26 +/- 29.30 ng/mg, u-alpha 2PI/CRE.index 121.53 +/- 43.57 ng/mg, u-PIC/CRE index 278.39 +/- 60.50 ng/mg) when compared with those of normal control group (u-FPA/CRE.index 0.92 +/- 0.04 ng/mg, u-B beta/CRE.index 12.15 +/- 0.44 ng/mg, u-alpha 2PI/CRE.index 4.18 +/- 0.33 ng/mg, u-PIC/CRE.index 5.98 +/- 1.15 ng/mg). Urinary urokinase markedly increased and urinary D-dimer was detected in severe cases of preeclampsia (u-UK/CRE.index 58.20 +/- 43.69 ng/mg, u-D-dimer 54.76 +/- 9.89 ng/ml) when compared with those of normal control group. These findings suggest that deficiency in urinary kinin excretion may induce hypertension in addition to the changes of urinary coagulation-fibrinolysis system that represents the occurrence of either the endothelial cell injury in the glomerulus or the renal tulbular damage in mild cases of preeclampsia, eventually resulting in the intra-renal vascular coagulation.
Mutoh
S
S
Division of Perinatal and Maternal Medicine, Akita University School of Medicine, Japan.
Kobayashi
M
M
Hirata
J
J
Itoh
N
N
Maki
M
M
Komatsu
Y
Y
Yoshida
A
A
Sasa
H
H
Kuroda
K
K
Kikuchi
Y
Y
D005260:Female; D005342:Fibrinolysis; D006801:Humans; D007610:Kallikreins / Q000652:urine*; D007705:Kinins / Q000652:urine*; D007703:Peptidyl-Dipeptidase A / Q000652:urine*; D011225:Pre-Eclampsia / Q000652:urine*; D011247:Pregnancy / Q000652:urine*; D012016:Reference Values; D000979:alpha-2-Antiplasmin / Q000652:urine*
D007705:Kinins; D000979:alpha-2-Antiplasmin; D007703:Peptidyl-Dipeptidase A; D007610:Kallikreins