Preeclampsia and the Kidney: Pathophysiology and Clinical Implications.

IF 4.2 2区 医学 Q1 PHYSIOLOGY
Virginia Dines, Sonja Suvakov, Andrea Kattah, Jane Vermunt, Kavita Narang, Muthuvel Jayachandran, Coline Abou Hassan, Alexander M Norby, Vesna D Garovic
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引用次数: 0

Abstract

Preeclampsia and other hypertensive disorders of pregnancy are major contributors to maternal morbidity and mortality worldwide. This group of disorders includes chronic hypertension, gestational hypertension, preeclampsia, preeclampsia superimposed on chronic hypertension, and eclampsia. The body undergoes important physiological changes during pregnancy to allow for normal placental and fetal development. Several mechanisms have been proposed that may lead to preeclampsia, including abnormal placentation and placental hypoxia, impaired angiogenesis, excessive pro-inflammatory response, immune system imbalance, abnormalities of cellular senescence, alterations in regulation and activity of angiotensin II, and oxidative stress, ultimately resulting in upregulation of multiple mediators of endothelial cell dysfunction leading to maternal disease. The clinical implications of preeclampsia are significant as there are important short-term and long-term health consequences for those affected. Preeclampsia leads to increased risk of preterm delivery and increased morbidity and mortality of both the developing fetus and mother. Preeclampsia also commonly leads to acute kidney injury, and women who experience preeclampsia or another hypertensive disorder of pregnancy are at increased lifetime risk of chronic kidney disease and cardiovascular disease. An understanding of normal pregnancy physiology and the pathophysiology of preeclampsia is essential to develop novel treatment approaches and manage patients with preeclampsia and hypertensive disorders of pregnancy. © 2023 American Physiological Society. Compr Physiol 13:4231-4267, 2023.

子痫前期与肾脏:病理生理学和临床意义。
先兆子痫和其他妊娠高血压疾病是全世界孕产妇发病率和死亡率的主要原因。这组疾病包括慢性高血压,妊娠高血压,子痫前期,子痫前期叠加慢性高血压和子痫。在怀孕期间,身体经历了重要的生理变化,以保证胎盘和胎儿的正常发育。已经提出了几种可能导致子痫前期的机制,包括胎盘异常和胎盘缺氧、血管生成受损、过度的促炎反应、免疫系统失衡、细胞衰老异常、血管紧张素II的调节和活性改变以及氧化应激,最终导致内皮细胞功能障碍的多种介质上调,从而导致母体疾病。先兆子痫的临床意义是显著的,因为有重要的短期和长期的健康后果的影响。子痫前期会增加早产的风险,增加胎儿和母亲的发病率和死亡率。子痫前期通常也会导致急性肾损伤,经历子痫前期或妊娠期其他高血压疾病的妇女终生患慢性肾脏疾病和心血管疾病的风险增加。了解正常妊娠生理和子痫前期的病理生理对开发新的治疗方法和管理子痫前期和妊娠高血压疾病患者至关重要。©2023美国生理学会。中国生物医学工程学报(英文版),2023。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
10.50
自引率
0.00%
发文量
38
审稿时长
6-12 weeks
期刊介绍: Comprehensive Physiology is the most authoritative and comprehensive collection of physiology information ever assembled, and uses the most powerful features of review journals and electronic reference works to cover the latest key developments in the field, through the most authoritative articles on the subjects covered. This makes Comprehensive Physiology a valued reference work on the evolving science of physiology for both researchers and clinicians. It also provides a useful teaching tool for instructors and an informative resource for medical students and other students in the life and health sciences.
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