The Level of Serum and Urinary Nephrin in Normal Pregnancy and Pregnancy with Subsequent Preeclampsia

Abstract

PurposeThe aim of this study was to evaluate serum and urinary nephrin levels of normal pregnancy to establish a standard reference value and to compare them with patients who subsequently developed preeclampsia (PE).Materials and MethodsIn this prospective study, 117 healthy singleton pregnancies were enrolled between 6 to 20 weeks of gestation at 2 participating medical centers during October 2010 to March 2012. Urine and serum samples were collected at the time of enrollment, each trimester, and at 4 to 6 weeks postpartum. Enzyme-linked immunosorbent assay for nephrin was performed and samples from patients who subsequently developed PE were compared to the normal patients.ResultsOf 117 patients initially enrolled, 99 patients delivered at the study centers and of those patients, 12 (12.1%) developed PE at a median gestational age of 34+4 weeks (range 29+5–36+6). In the normal patients (n=68), serum nephrin level decreased and urinary nephrin level increased during the latter of pregnancy. In 12 patients who subsequently developed PE, a significant rise in the 3rd trimester serum and urinary nephrin levels, compared to the controls, was observed (p<0.001), and this increase occurred 9 days prior to the onset of clinical disease.ConclusionAs the onset of PE was preceded by the rise in the serum and urinary nephrin in comparison to normal pregnancy, serum and urinary nephrin may be a useful predictive marker of PE.

Serum Nephrin Levels in Severe Preeclampsia: A Cross-Sectional Study

“…This is contrary to urinary nephrin levels, increase along the gestational age and decreases during postpartum. 21,23 The relationship between serum nephrin levels with BP, obtained a weak and signifi cant correlation with systolic with r = 0.36 and p = 0.02 (p <0.05) whereas at diastolic obtained a weak correlation with r = 0.30 but not signifi cant with p = 0.05 (p> 0.05). In this study, isolated systolic hypertension may occur so that a signifi cant correlation exists only in systolic blood pressure.…”

Podocytes—The Most Vulnerable Renal Cells in Preeclampsia

“…Wang has found that urine nephrin levels correlate with the severity of proteinuria—in other words, the more severe podocyte and slit diaphragm damage the more pronounced the proteinuria [ 19 ]. Jung has noticed that increased urine concentrations of nephrin predate the signs of preeclampsia by an average of nine days [ 20 ]. Additionally, other authors have observed that urinary levels of nephrin are higher in PE patients than both in control group women and patients with gestational hypertension [ 21 ].…”

Preeclampsia: a gestational cardiorenal syndrome

“…) and increased nephrin concentrations in serum and urine (Jung et al . ), but also via thrombotic micro‐angiopathy (Johnson & Nangaku, ). The latter results from increased arterial and venous resistance by inhibition of endothelial NO‐mediated gestational vasodilatation, sympathetic sensitivity (van Drongelen et al .…”

“…Both factors are needed for a normal function of the glomerular endothelium (Henao et al 2010). Disrupted endothelial function triggers further impairment of renal function via induction of podocyte dysfunction, with subsequent podocyturia (Craici et al 2014) and increased nephrin concentrations in serum and urine (Jung et al 2017), but also via thrombotic micro-angiopathy (Johnson & Nangaku, 2016). The latter results from increased arterial and venous resistance by inhibition of endothelial NO-mediated gestational vasodilatation, sympathetic sensitivity (van Drongelen et al 2014) and relaxin (Conrad & Davison, 2014).…”