ABSTRACT
INTRODUCTION: Preeclampsia (PE) is an important cause of glomerulopathy. Assessment of renal markers during pregnancy may have a predictive value for glomerular disease later in life. The early detection of PE may prevent the complications of this syndrome. OBJECTIVES: Assess the glomerular involvement in PE and in normal pregnancy by evaluating renal markers such as podocyturia and proteinuria. METHODS: Case-control study with 39 pregnant women after 20 weeks of gestation (control group - CG with n=25 and PE with n=14), we assessed podocyturia (cytospin method) and proteinuria (albuminuria, urine protein:creatinine - PCR, urinary retinol protein - RBP and albumin/creatinine ratio - ACR). (Grant FAPESP 08/56338-1) RESULTS: Mean±standard deviation of age and mean gestational age of CG were 26.9±6.4years and 37.1±5.0weeks and of PE, 26.4±6.9 and 30.6±5.6, respectively (p=0.001). No statistical differences were found between podocyturia in CG and PE although it was more frequent in this last group (p=0.258). Podocyte cells and parietal epithelial cells were detected in the slides. Mean±standard deviation of urinary RBP (p=0.017), albuminuria (p=0.002) and UAC ratio (p=0.006) of CG were 0.4±0.7mg/L, 7.3±6.9mg/L and 8.2±6.7mg/g and of PE, 2.0±4.4mg/L, 2267.4±2130.8mg/L (p=0.002) and 3778.9±4296.6mg/g (p=0.006), respectively. Mean value±standard deviation of urine PCR in PE was 6.7±6.1g/g (p=< 0.001). CONCLUSION: Urinary RBP, PCR, albuminuria and UAC ratio were elevated in PE in comparison to CG indicating its glomerular involvement but there was no correlation between those renal parameters and podocyturia. RPC and UAC ratios were good predictors of PE, but not podocyturia. Either podocyte cells as parietal epithelial cells were detected in the urine, these findings may indicate a non-invasive marker for renal disease activity but more studies are required to determine its role in PE.
ABSTRACT
INTRODUCTION: Preeclampsia (PE) is a major cause of maternal and perinatal mobility and mortality and its etiology is not yet completely understood. Recently studies have shown the association between increased expression of glycosaminoglycans (GAGs) in placental of women with PE and its physiopathology. OBJECTIVES: Identify and quantify GAGs in placental of pregnant women in healthy pregnancy and PE. METHODS: Case-control study with 44 patients, control group (CG) n=29 and n=15 PE group. All patients were submitted to placental tissue resection (sample size of 5×5cm with the umbilical cord insertion in the center). The tissue was conserved in acetone. The GAGs' analysis consisted of centrifugation, proteolysis, precipitation, and electrophoresis RESULTS: Average age and gestational age in CG and PE were 27.33years and 39.02weeks and 24.17 and 36.90, respectively. In CG 68.96% (20/29) were Caucasian and 80.00% (12/15) in PE. We found in CG 34.48% (10/29) of primiparous and 40.00% (6/15) in PE. The average 24-hour proteinuria in PE was 554.28g/24hs. The average birth weight was 3333.31g in CG and 2972.66 in PE. The mean ± standard deviation of dermatan sulfate (DS), heparan sulfate (HS) and hyaluronic acid (HA) in CG and PE were: 0,100µg/mg of tissue ±0,005 and 0,144 ±0,071; 0,077±0,041 and 0,113±0,061; 1,281±1,857 and 3,076±4,930. CONCLUSION: GAGs are increased in PE when compared to normal pregnancy. The expression of HA and HS was twice higher in PE. More studies are needed to determine the correlation between GAGs and physiopathology of PE.
