Angiogenesis placental factors imbalance and clinical features of “early” and “late” pre-eclampsia

Abstract

Nephrological manifestations of “early” and “late” pre-eclampsia (PE) are described. Clinical manifestations are analyzed with consideration for the placental angiogenesis markers: VEGF and sFlt-1. Women with early PE (gestation age Me32 [29; 34] weeks) had higher systolic and diastolic BP (170 ± 16.8 vs. 156 ± 6.56 mm Hg and 105 ± 8.9 vs. 99 ± 6.9 mm Hg, respectively), 4-fold higher incidence of renal dysfunction, presented by low glomerular filtration rate (GFR; Me 70 [51; 80] ml/min) and/or high serum creatinin levels (Me 90 [78; 102] мmol/liter), 7-fold higher incidence of the nephrotic syndrome, and 3-fold higher level of sFlt-1 than patients with late PE (gestation age Me 38 [36; 39] weeks). Inverse correlation between GFR and sFlt-1 (r = -0.42; p = 0.050) and direct correlation between GFR and VEGF (r = 0.47; p = 0.038) were detected in PE patients. The contribution of angiogenesis placental markers imbalance to the formation of proteinuria, arterial hypertension, and renal dysfunction in PE and the contribution of thrombophilia to PE development are discussed.

Keywords

pre-eclampsia / glomerular involvement / vascular endothelial growth factor (VEGF) / soluble fms-like tyrosine kinase 1 (sFlt-1) / arterial hypertension / glomerular filtration rate / proteinuria / podocynuria

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