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Medline ® Abstract for Reference 7

of 'Maternal adaptations to pregnancy: Renal and urinary tract physiology'

Course of preeclamptic glomerular injury after delivery.
Hladunewich MA, Myers BD, Derby GC, Blouch KL, Druzin ML, Deen WM, Naimark DM, Lafayette RA
Am J Physiol Renal Physiol. 2008 Mar;294(3):F614-20. Epub 2008 Jan 16.
We evaluated the early postpartum recovery of glomerular function over 4 wk in 57 women with preeclampsia. We used physiological techniques to measure glomerular filtration rate (GFR), renal plasma flow, and oncotic pressure (pi(A)) and computed a value for the two-kidney ultrafiltration coefficient (K(f)). Compared with healthy, postpartum controls, GFR was depressed by 40% on postpartum day 1, but by only 19% and 8% in the second and fourth postpartum weeks, respectively. Hypofiltration was attributable solely to depression, at corresponding postpartum times, of K(f) by 55%, 30%, and 18%, respectively. Improvement in glomerular filtration capacity was accompanied by recovery of hypertension to near-normal levels and significant improvement in albuminuria. We conclude that the functional manifestations of the glomerular endothelial injury of preeclampsia largely resolve within the first postpartum month.
Division of Nephrology, Department of Medicine, University of Toronto, Toronto, Ontario, Canada. michelle.hladunewich@sunnybrook.ca