[Preeclampsia and tubular dysfunction].
Renal involvement associated with preeclampsia is well investigated, especially from the aspect of glomerular lesion and coagulation. On the other hand, only a few studies on tubular dysfunction during normal pregnancy and preeclampsia have been reported. The first study was carried out to clarify and estimate the chronological changes in tubular function. Pregnant women without obvious tubular dysfunction and toxemia (group A) were investigated using serum Cl, Na minus Cl (Na-Cl index), uric acid and urinary beta 2-microglobulin (u-beta-MG) at the 10th, 20th, 30th and 36th weeks of gestation. The second study was carried out to determine the significance of tubular dysfunction accompanied by preeclampsia. Patients with severe preeclampsia (group B) and normal pregnancy (group C) were examined by the same index of tubular dysfunction. The diagnosis of severe preeclampsia was confirmed with hypertension (over 170/110 mmHg), proteinuria (beyond 3 g/day) and severe edema. The following results were obtained: Urinary beta-MG and serum Cl increased during the third trimester in group A, but the Na-Cl index decreased. The serum uric acid concentration increased during the third trimester in group A. Tubular dysfunction was evident during the third trimester in normal pregnancy. Every index of tubular dysfunction including u-beta-MG, serum Cl, Na-Cl index and uric acid in group B was significantly higher than in group C. In group B, 4 fetuses died and 7 out of 15 cases required Cesarean sections. The critical line of tubular dysfunction for fetal prognosis was Cl 110 mEq/l, Na-Cl index 28 mEq/l, uric acid 6.0 mg/dl and u-beta-MG 1,000 micrograms/l.(ABSTRACT TRUNCATED AT 250 WORDS)
D002713:Chlorine / Q000097:blood; D005260:Female; D006801:Humans; D007684:Kidney Tubules / Q000503:physiopathology*; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D012964:Sodium / Q000097:blood; D014527:Uric Acid / Q000097:blood; D001613:beta 2-Microglobulin / Q000652:urine
D001613:beta 2-Microglobulin; D014527:Uric Acid; D002713:Chlorine; D012964:Sodium