Podocyturia as a Marker for Preeclampsia

Abstract

The role of kidneys in the pathogenesis of preeclampsia is still a matter of debate. There is strong evidence that a disturbance in the function of normal kidney due to the loss of podocytes is the main cause of the development of proteinuria and hypertension. The release of podocytes, podocytic proteins and podocytic matrix ribonucleic acid (mRNA) can both be used for the diagnostics of preeclampsia and serve as a marker of the active disease of the kidney. The performed in this review analysis of publications showed that podocytes and podocytic proteins can be detected long before the appearance of proteinuria and hypertension, which makes them promising markers for the early diagnosis of preeclampsia. Measurement of the concentration of nephrin and its mRNA allows both assess the risk of development of preeclampsia and make the differential diagnosis between preeclampsia and gestational hypertension with a sufficiently high efficiency already in the second trimester of pregnancy, long before the appearance of the main signs of the disease.

Impact of Preventive Therapy on Regulating Mechanisms of Decidual Macrophage Polarization in Pregnant Women With High Risk of Preeclamplsia

“…• imbalance of pro-and anti-inflammatory cytokines leads to an imbalance of enzymes that regulate L-arginine metabolism, with an increase in iNOS activity and a significant decrease in arginase activity [13,15]; • decidual macrophages of the M1 subpopulation dominate in the placenta (due to the stimulating effect of INF-γ and activation of inducible NO synthase), which causes placental dysfunction in the second and early third trimester of pregnancy (because activated M1 macrophages cause cytotoxic effects on placental tissue). [11,16]; • there is a non-physiological decrease in the subpopulation of M2 in the placenta during pregnancy, which causes more frequent complications of pregnancy and childbirth [1,9,16]).…”