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Preeclampsia: Angiogenic Factors, Blood Pressure, and the Kidney

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Chronic Kidney Disease and Hypertension

Part of the book series: Clinical Hypertension and Vascular Diseases ((CHVD))

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Abstract

Despite being one of the leading causes of maternal death and a major contributor of maternal and perinatal morbidity, the mechanisms responsible for the pathogenesis of preeclampsia (PE) have yet to be fully elucidated. PE affects the vasculature of many target maternal organs including the kidney, liver, and brain. Growing evidence supports the concept that the placenta plays a central role in the pathogenesis of PE and that reduced uteroplacental perfusion which develops as a result of abnormal cytotrophoblast invasion of spiral arterioles triggers the cascade of events leading to the maternal disorder. The hypoxic placenta in turn releases a variety of soluble factors which that generate widespread dysfunction of the maternal vascular endothelium. This dysfunction manifests as enhanced formation of factors such as endothelin, reactive oxygen species, and augmented vascular sensitivity to angiotensin II. In addition, PE is also associated with decreased formation of vasodilators such as nitric oxide and prostacyclin. The full elucidation of the molecular and cellular mechanisms involved in various stages of the disease process will hopefully lead to a more complete understanding of the etiology of PE and eventually lead to successful therapeutic intervention through the targeted disruption of novel pathways.

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Authors and Affiliations

  1. Department of Physiology and Biophysics, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, 39216, USA

    Frank T. Spradley, Eric Matthew George, Ana Carolina Palei, Junie Paula Warrington & Joey P. Granger

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  1. Frank T. Spradley
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  2. Eric Matthew George
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  3. Ana Carolina Palei
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  4. Junie Paula Warrington
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  5. Joey P. Granger
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Editor information

Editors and Affiliations

  1. Division of Nephrology, University of Maryland School of Medicine, Baltimore, Maryland, USA

    Matthew R. Weir

  2. Section of Nephrology, University of Illinois at Chicago/Advocate Christ Medical Center, Oak Lawn, Illinois, USA

    Edgar V. Lerma

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Spradley, F., George, E., Palei, A., Warrington, J., Granger, J. (2015). Preeclampsia: Angiogenic Factors, Blood Pressure, and the Kidney. In: Weir, M., Lerma, E. (eds) Chronic Kidney Disease and Hypertension. Clinical Hypertension and Vascular Diseases. Humana Press, New York, NY. https://doi.org/10.1007/978-1-4939-1982-6_13

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  • DOI: https://doi.org/10.1007/978-1-4939-1982-6_13

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  • Publisher Name: Humana Press, New York, NY

  • Print ISBN: 978-1-4939-1981-9

  • Online ISBN: 978-1-4939-1982-6

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