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Kurlak LO, Broughton Pipkin F, Mohaupt MG, et al. Responses of the renin-angiotensin-aldosterone system in pregnant chronic kidney disease patients with and without superimposed pre-eclampsia. Clin Kidney J. 2019;12(6):847-854doi: 10.1093/ckj/sfz025.
Kurlak, L. O., Broughton Pipkin, F., Mohaupt, M. G., & Mistry, H. D. (2019). Responses of the renin-angiotensin-aldosterone system in pregnant chronic kidney disease patients with and without superimposed pre-eclampsia. Clinical kidney journal, 12(6), 847-854. https://doi.org/10.1093/ckj/sfz025
Kurlak, Lesia O, et al. "Responses of the renin-angiotensin-aldosterone system in pregnant chronic kidney disease patients with and without superimposed pre-eclampsia." Clinical kidney journal vol. 12,6 (2019): 847-854. doi: https://doi.org/10.1093/ckj/sfz025
Kurlak LO, Broughton Pipkin F, Mohaupt MG, Mistry HD. Responses of the renin-angiotensin-aldosterone system in pregnant chronic kidney disease patients with and without superimposed pre-eclampsia. Clin Kidney J. 2019 Mar 25;12(6):847-854. doi: 10.1093/ckj/sfz025. eCollection 2019 Dec. PMID: 31807298; PMCID: PMC6885683.
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Clin Kidney J. 2019 Mar 25;12(6):847-854. doi: 10.1093/ckj/sfz025. eCollection 2019 Dec.

Responses of the renin-angiotensin-aldosterone system in pregnant chronic kidney disease patients with and without superimposed pre-eclampsia.

Clinical kidney journal

Lesia O Kurlak, Fiona Broughton Pipkin, Markus G Mohaupt, Hiten D Mistry

Affiliations

  1. Division of Child Health, Obstetrics & Gynaecology, University of Nottingham, Nottingham, UK.
  2. Internal Medicine, Teaching Hospital Lindenhofgruppe, Bern, Switzerland.

PMID: 31807298 PMCID: PMC6885683 DOI: 10.1093/ckj/sfz025

Abstract

BACKGROUND: Women with chronic kidney disease (CKD) are at increased risk of superimposed pre-eclampsia (SPE). Accurate identification of SPE is challenging. We hypothesized that specific components of the renin-angiotensin-aldosterone system (RAAS) would discriminate between CKD and SPE. The aim of the study was to establish differences in circulating and intrarenal RAAS in women with CKD with and without SPE and compare these to normotensive controls (NCs) and women with pre-eclampsia (PE).

METHODS: White European NC women (

RESULTS: Urinary TH-aldo:creatinine ratios were lower in women with PE or SPE compared with NC or women with CKD (P

CONCLUSIONS: Women with SPE have a lower urinary TH-aldo:creatinine ratio, lower plasma active renin and lower PlGF concentrations than women with CKD, comparable to women with PE without pre-existing disease, suggestive of similar pathophysiology. These data suggest disruption of the RAAS pathway in SPE similar to PE. Exploration of the predictive value of RAAS components for adverse pregnancy events in women with CKD is required.

© The Author(s) 2019. Published by Oxford University Press on behalf of ERA-EDTA.

Keywords: chronic kidney disease; hypertension in pregnancy; pre-eclampsia; renin-angiotensin-aldosterone system; urinary angiotensinogen

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