title: Higher filtration fraction in formerly early-onset preeclamptic women without comorbidity.
abstract: Formerly preeclamptic women have an increased risk for developing end-stage renal disease, which has been attributed to altered renal hemodynamics and abnormalities in the renin-angiotensin-aldosterone system. Whether this is due to preeclampsia itself or to comorbid conditions is unknown. Renal hemodynamics and responsiveness to ANG II during low Na(+) intake (7 days, 50 mmol Na(+)/24 h) and high Na(+) (HS) intake (7 days, 200 mmol Na(+)/24 h) were studied in 18 healthy normotensive formerly early-onset preeclamptic women (fPE women) and 18 healthy control subjects (fHP women), all selected for absence of comorbidity. At the end of each diet, renal hemodynamics and blood pressure were measured before and during graded ANG II infusion. Both HS intake and former preeclampsia increased filtration fraction (FF) without an interaction between the two. FF was highest during HS intake in fPE women [0.31 ± 0.12 vs. 0.29 ± 0.11 in fHP women, generalized estimating equation analysis (body mass index corrected), P = 0.03]. The renal response to ANG II infusion was not different between groups. In conclusion, fPE women have a higher FF compared with fHP women. As this was observed in the absence of comorbidity, preeclampsia itself might exert long-term effects on renal hemodynamics. However, we cannot exclude the presence of prepregnancy alterations in renal function, which, in itself, lead to an increased risk for preeclampsia. In experimental studies, an elevated FF has been shown to play a pathogenic role in the development of hypertension and renal damage. Future studies, however, should evaluate whether the subtle differences in renal hemodynamics after preeclampsia contribute to the increased long-term renal risk after preeclampsia.
authors.affiliation: Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;
authors.forename: Tsjitske J
authors.initials: TJ
authors.lastname: Toering
authors.affiliation: Department of Pathology and Medical Biology, Division of Medical Biology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;
authors.forename: Anne Marijn
authors.initials: AM
authors.lastname: van der Graaf
authors.affiliation: Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;
authors.forename: Folkert W
authors.initials: FW
authors.lastname: Visser
authors.affiliation: Department of Epidemiology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands; and.
authors.forename: Henk
authors.initials: H
authors.lastname: Groen
authors.affiliation: Department of Pathology and Medical Biology, Division of Medical Biology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;
authors.forename: Marijke M
authors.initials: MM
authors.lastname: Faas
authors.affiliation: Department of Internal Medicine, Division of Nephrology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands;
authors.forename: Gerjan
authors.initials: G
authors.lastname: Navis
authors.affiliation: Department of Obstetrics and Gynecology, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands a.t.lely@umcutrecht.nl.
authors.forename: A Titia
authors.initials: AT
authors.lastname: Lely
mesh_terms: D000328:Adult; D000804:Angiotensin II / Q000008:administration & dosage; D001794:Blood Pressure; D015897:Comorbidity; D018592:Cross-Over Studies; D004039:Diet, Sodium-Restricted; D004305:Dose-Response Relationship, Drug; D005260:Female; D005865:Gestational Age; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007262:Infusions, Intravenous; D007668:Kidney / Q000187:drug effects / Q000503:physiopathology*; D007676:Kidney Failure, Chronic / Q000175:diagnosis / Q000208:ethnology / Q000209:etiology* / Q000503:physiopathology; D009426:Netherlands / Q000453:epidemiology; D011225:Pre-Eclampsia / Q000175:diagnosis / Q000208:ethnology / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011247:Pregnancy; D017596:Renal Plasma Flow, Effective; D012084:Renin-Angiotensin System / Q000187:drug effects; D012307:Risk Factors; D012982:Sodium, Dietary / Q000008:administration & dosage; D044465:White People
chemical_list: D012982:Sodium, Dietary; D000804:Angiotensin II
keywords: Na+ intake; postpartum; preeclampsia; renal hemodynamics; renin-angiotensin-aldosterone system