Serum cystatin C reflects glomerular endotheliosis in normal, hypertensive and pre-eclamptic pregnancies.
OBJECTIVE
To study the correlation between serum cystatin C levels and renal structural changes in normal, hypertensive and pre-eclamptic pregnancy to evaluate it as a marker of the degree of renal involvement in pre-eclampsia.


METHODS
An observational prospective study.


METHODS
University Hospital of Lund, Sweden.


METHODS
Thirty-six women with hypertensive disease in pregnancy and 12 healthy pregnant women in the third trimester recruited from maternal health care centres in the catchment area of the hospital.


METHODS
Renal biopsy samples were obtained from all participants and the degree of endotheliosis as well as the mean glomerular volume was evaluated by light microscopy in silver methenamin-stained sections. Serum cystatin C levels were measured and correlated to the structural changes.


METHODS
Correlation among degree of glomerular endotheliosis, glomerular volume and serum cystatin C.


RESULTS
Serum cystatin C levels differed between the different degrees of endotheliosis, showing a highly significant increasing linear trend. They also correlated significantly with glomerular volume (r = 0.60, P < 0.001). Mean serum urate and creatinine levels also increased with the degree of endotheliosis, but not above the reference interval for normal term pregnancy, even in pre-eclamptic women.


CONCLUSIONS
Serum cystatin C may be used as a marker, not only for impaired renal function, but also for the degree of glomerular endotheliosis and increase in glomerular volume in pregnancy. It may be of value in the monitoring of pregnancies complicated by pre-eclampsia.
D000328:Adult; D015415:Biomarkers / Q000097:blood; D055316:Cystatin C; D015891:Cystatins / Q000097:blood*; D004730:Endothelium, Vascular; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000209:etiology / Q000473:pathology; D007674:Kidney Diseases / Q000097:blood / Q000209:etiology / Q000473:pathology*; D007678:Kidney Glomerulus / Q000098:blood supply / Q000473:pathology*; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology / Q000473:pathology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000209:etiology / Q000473:pathology*; D011249:Pregnancy Complications, Cardiovascular / Q000097:blood / Q000209:etiology / Q000473:pathology; D011446:Prospective Studies
D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D015891:Cystatins