Endothelial and kidney function in women with a history of preeclampsia and healthy parous controls: A case control study

Introduction: Preeclampsia (PE) is a pregnancy related endothelial disease characterized by hypertension and albuminuria. Postpartum endothelial dysfunction often persists in these women. We postulate that in women with a history of PE reduced endothelial dependent vasodilation coincides with attenuated kidney function, as both reflect endothelial dysfunction. Methods: We assessed endothelial and kidney function in women with a history of PE (n = 79) and uncomplicated pregnancies (n = 49) at least 4 years postpartum. Women with hypertension, diabetes or kidney disease prior to pregnancy were excluded. Brachial artery flow mediated dilatation (FMD) was measured and analysed by a custom designed edge-detection and wall-tracking software. We measured albumin and creatinine levels in a 24-h urine sample and calculated glomerular filtration rate (GFR) by CKD-EPI. Results: Women with a history of PE had lower FMD but comparable GFR and albumin creatinine ratio (ACR) compared with controls. Independent of obstetric history, in both controls and women with a history of PE respectively, GFR (r = 0.19, p = 0.17 and r = 0.12, p = 0.29) and albumin creatinine ratio (r = 0.07, p = 0.62 and r = 0.06 p = 0.57) did not correlate with FMD. Conclusion: At least 4 years after pregnancy, women with a history of PE demonstrated decreased flow mediated dilatation when compared to healthy parous controls. In this study, decreased flow mediated dilation however did not coincide with decreased kidney function.