Kidney Week

Abstract: TH-PO758

Involvement of Tubulo-Interstitial Impairment in the Renal Disorders Associated With Hypertensive Disorder in Pregnancy (HDP)

Session Information

• Sex and Reproductive Factors in Kidney Health
  November 03, 2022 | Location: Exhibit Hall, Orange County Convention Center‚ West Building
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Sato, Mariko, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Mariko Sato,

• Takayanagi, Kaori, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Kaori Takayanagi,

• Ogawa, Koki, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Koki Ogawa,

• Sawada, Erika, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Erika Sawada,

• Yasui, Atsuko, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Atsuko Yasui,

• Iwashita, Takatsugu, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Takatsugu Iwashita,

• Ogawa, Tomonari, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Tomonari Ogawa,

• Maeshima, Akito, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Akito Maeshima,

• Hasegawa, Hajime, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan

Hajime Hasegawa,

Background

Renal involvement is frequently complicated in the Hypertensive Disorder in Pregnancy (HDP). Since enlargement of glomerular endothelial cells (endotheliosis) is observed in HDP, glomerular disorder has been considered as the principal locus of renal involvement in HDP. In the meantime, the vasospasm in the HDP is believed to be observed not only in the placenta but also systemically, and the involvement of the vasoconstriction-related tubulo-interstitial disorder (TID) is also speculated in the kidney, but the report is limited. In this study, we aim to investigate time-differential changes in multiple parameters with TID to examine its participation in HDP.

Methods

Twenty patients diagnosed with HDP at obstetrics department were prospectively studied. Three blood and urine samples around 30 weeks of gestation (P1), around 38 weeks of gestation (P2) and 1 month postpartum (P3) were used for the analysis. Mean home-measured morning blood pressure (BP) during the 3 days before sample collection was used as BP value.

Results

The mean age was 35.5 years, and half were taking methyldopa orally (mean 825 mg/day). Mean systolic BP was P1: 121.1, P2: 128.8, and P3: 122.3 mmHg. The median urine Alb was P1: 12.9, P2: 24.2, P3 30 2 mg/gCr, and there were few cases with overt albuminuria or proteinuria in this population. Among TID-related parameters, urine MCP-1, in urine NAG, urine activin and urine alpha1-MG, differences were observed in P1, P2 and P3. When stratified into high BP group (BPH) and low BP group (BPL) at systolic BP level of P1, there was a difference in the median value between BPH and BPL in urine MCP-1 (BPH P1: 1076.3, P2: 1098.1, P3: 358.0; BPL P1: 644.4, P2: 582.5, P3: 333.9) and urine NAG.

Conclusion

The changes of multiple TID parameters during the course of gestation, and the relevance of TID parameters with the degree of blood pressure at P1 phase might suggest an association between the severity of HDP and TID. In conclusion, it was suggested that the renal TID might be involved in HDP regardless of the existence of proteinuria.