title: PP108. Post-partum evaluation of the blood pressure and the kidney function in pre-eclamptic women.
abstract: BACKGROUND
  Recent data have shown that preeclampsia is not just a disease of pregnancy that resolves with delivery. Preeclampsia may be considered a 'risk marker' for later-life diseases, including cardiovascular and renal diseases and the metabolic syndrome.
  
  
  OBJECTIVE
  We aimed a longitudinal prospective study to analyze the renal abnormalities in the post-partum.
  
  
  METHODS
  We studied 127 post-preeclamptic women at 6 weeks post-partum. Twenty-four hour urine collection, ambulatory blood pressure and renal function were evaluated.
  
  
  RESULTS
  The mean age (±SD) was 32±6years, BMI was 29.4±5.7, the race distribution was Caucasian 69%, Hispanic 14%, Black 12% and Orient 5%. Ten % were active smokers, 10% have been suffering from gestational diabetes. The mean duration of the pregnancy was 36 weeks 3/7±4. Our results show that the prevalence of hypertension defined by office blood pressure ⩾140/90 mmHg or ongoing antihypertensive treatment was 35%. The daytime ambulatory blood pressure (ABPM) was 122±16/85±11 mmHg, heart rate 84±8, and 111±20/75±11 mmHg at nighttime.Sixteen % had a daytime ABPM ⩾135/85mmHg corresponding to the definition of ambulatory hypertension. Ultrasensitive CRP was 4.9±5.1mg/ml, of them 31% had a frank elevation of the CRP >4. The glomerular filtration rate evaluated by the Gault-Cockroft equation showed a hyperfiltration with a mean value of 150±42ml/min. Eleven% had a decreased GFR < 90 ml/min. Microalbumine/creatinine ratio measured in the urine spot was 7 ±4. Mean microalbuminuria was 225±529mg/d measured on the 24h urine collection.Urine 24h Na excretion rate was 204±48 mmol/d.
  
  
  CONCLUSIONS
  In conclusion, after the post-partum period, women having suffered from a pre-eclampsia display many cardiovascular risk factors with a high prevalence of hypertension, microalbuminuria, renal hyperfiltration and elevated CRP. These women should be carefully screened, and sub-groups with the higher risk have to be targeted for prevention and treatment, and close follow-up.
authors.affiliation: Hypertension Unit, University Hospital Geneva, Switzerland.
authors.forename: A
authors.initials: A
authors.lastname: Pechère-Bertschi
authors.affiliation: Hypertension Unit, University Hospital Geneva, Switzerland.
authors.forename: P
authors.initials: P
authors.lastname: Montillier
authors.affiliation: Obstetrics, University Hospital, Geneva 4, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Boulvain
authors.affiliation: Nephrology, CHUV, Lausanne, Switzerland.
authors.forename: G
authors.initials: G
authors.lastname: Wuerzner
authors.affiliation: Primary Care and Emergencies, University Hospital, Geneva 4, Switzerland.
authors.forename: J-M
authors.initials: JM
authors.lastname: Gaspoz
authors.affiliation: Nephrology, CHUV, Lausanne, Switzerland.
authors.forename: M
authors.initials: M
authors.lastname: Burnier
authors.affiliation: Obstetrics, University Hospital, Geneva 4, Switzerland.
authors.forename: O P
authors.initials: OP
authors.lastname: Irion