Course of preeclamptic glomerular injury after delivery.
We evaluated the early postpartum recovery of glomerular function over 4 wk in 57 women with preeclampsia. We used physiological techniques to measure glomerular filtration rate (GFR), renal plasma flow, and oncotic pressure (pi(A)) and computed a value for the two-kidney ultrafiltration coefficient (K(f)). Compared with healthy, postpartum controls, GFR was depressed by 40% on postpartum day 1, but by only 19% and 8% in the second and fourth postpartum weeks, respectively. Hypofiltration was attributable solely to depression, at corresponding postpartum times, of K(f) by 55%, 30%, and 18%, respectively. Improvement in glomerular filtration capacity was accompanied by recovery of hypertension to near-normal levels and significant improvement in albuminuria. We conclude that the functional manifestations of the glomerular endothelial injury of preeclampsia largely resolve within the first postpartum month.
Hladunewich
M A
MA
Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. michelle.hladunewich@sunnybrook.ca
Myers
B D
BD
Derby
G C
GC
Blouch
K L
KL
Druzin
M L
ML
Deen
W M
WM
Naimark
D M
DM
Lafayette
R A
RA
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D005919:Glomerular Filtration Rate / Q000502:physiology*; D006801:Humans; D007678:Kidney Glomerulus / Q000503:physiopathology*; D008954:Models, Biological; D049590:Postpartum Period / Q000502:physiology; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy