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Preeclampsia and Glomerulonephritis: A Bidirectional Association

  • Preeclampsia (V Garovic, Section Editor)
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Abstract

Purpose of Review

We focus on the current understanding of preeclampsia (PE) in order to examine how it mediates glomerular injury and affects the course of glomerulonephritis (GNs). In addition, this review discusses the role of GNs on the development of PE.

Recent Findings

In PE, the dysfunctional utero-placental perfusion causes the release into the mother’s circulation of anti-angiogenic substances, leading to systemic endotheliosis. In preeclamptic patients, the imbalance between pro- and anti-angiogenic factors is responsible for the kidney injury, and PE may reveal a silent pre-existent GN or may induce the development of the disease. Moreover, in women with chronic kidney disease (CKD), it could accelerate the disease progression. In any case, GNs compromise renal function, making the kidney less responsive to physiological changes that occur during pregnancy and, at the same time, cause maternal vascular inflammation, representing a risk factor for PE development.

Summary

Although a bidirectional correlation between GNs and PE has been demonstrated, the data are limited, and further large studies are warranted. Close collaboration between a multidisciplinary team of obstetricians and nephrologists is essential to establish the correct diagnosis and safely manage these vulnerable women and their fetuses.

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Authors and Affiliations

  1. Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, University of Bari Aldo Moro, Bari, Italy

    Vincenzo Di Leo, Flavia Capaccio & Loreto Gesualdo

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  1. Vincenzo Di Leo
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  2. Flavia Capaccio
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  3. Loreto Gesualdo
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Correspondence to Loreto Gesualdo.

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Di Leo, V., Capaccio, F. & Gesualdo, L. Preeclampsia and Glomerulonephritis: A Bidirectional Association. Curr Hypertens Rep 22, 36 (2020). https://doi.org/10.1007/s11906-020-1033-9

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