title: Preeclampsia: is it because of the asymptomatic, unrecognized renal scars caused by urinary tract infections in childhood that become symptomatic with pregnancy?
abstract: Preeclampsia is an important disease of pregnancy whose exact etiology is still unknown despite continuing developments in medicine. Although most commonly it is believed to be caused by a defective placentation, in this paper, we hypothesize that the primary underlying problem in the development of preeclampsia can be in kidneys in a greater proportion of cases than it is believed today. The increased intravascular volume and the increased work load of kidneys together with the resulting glomerular hypertrophy may precipitate nephrotic syndrome, which in this case is called "preeclampsia" in a previously affected kidney. Urinary tract infections in childhood leaving silent, unrecognized small scars in the kidneys may be the underlying renal cause which disrupts its silence with an increased work load of kidneys prominently occurring after the midtrimester. The histopathologic finding in kidneys with renal scars after childhood urinary tract infections and in preeclampsia is focal segmental glomerulosclerosis in the majority of cases and this similarity strengthens our hypothesis.
authors.affiliation: Abant İzzet Baysal University, Faculty of Medicine, Department of Obstetrics and Gynecology, Bolu, Turkey. tulaybozkurt2@yahoo.com
authors.forename: Tülay
authors.initials: T
authors.lastname: Ozlü
authors.forename: Aytekin
authors.initials: A
authors.lastname: Alçelik
authors.forename: Billur
authors.initials: B
authors.lastname: Calişkan
authors.forename: Melahat Emine
authors.initials: ME
authors.lastname: Dönmez
mesh_terms: D002921:Cicatrix / Q000473:pathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology*; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D014552:Urinary Tract Infections / Q000150:complications*