Soluble Factors and Renal Outcome in Preeclampsia

Study Overview
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Brief Summary
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Preeclampsia (PE) is an important complication of pregnancy and can lead to chronic kidney disease by causing endothelial damage and podocyte loss, Soluble forms-like tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), sFlt1 / PlGF ratio and endoglin are the biomarkers for the differential diagnosis of preeclampsia and other diseases. We aim to explore the correlation of these biomarkers with long term renal function, blood pressure and urine albumin creatinine ratio (UACR) in PE patients.

Detailed Description
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This is prospective observational study.Study subjects are pregnant women aged more than 18 years more than 24 weeks of gestation who were diagnosed and classified as preeclampsia or gestational hypertension by the criteria recommends by the American College of Obstetricians and Gynecologists (ACOG).14 Severe preeclampsia will be diagnosed by: A systolic/diastolic blood pressure ≥ 140 mmHg occurring on two occasions at least 4 hours apart after 20 weeks of gestation a women whose blood pressure has previously been normal Proteinuria with excretion of 0.3 gm or more of protein in a 24 hour urine specimen or urine dipstick results of at least 1+(30 mg per deciliter) on two occasions The exclusion criteria were chronic hypertension before pregnancy ,chronic kidney disease according to KDIGO criteria15 ,twin pregnancies,underlying diabetes mellitus .Of the 42 women enrolled in this trial,we excluded 2 patients who had twin pregnancies and history of diabetes mellitus. Eight women were lost to follow up. The remaining 32 patients completed the study. Data collection and Laboratory Measurements Baseline demographic and clinical data will be recorded as follows: age, gestational age, blood pressure, medication history, parity. Laboratory data included complete blood count, blood urea nitrogen (BUN), creatinine, aspartate aminotransferase (AST), alanine aminotransferase (ALT), albumin, alkaline phosphate, lactate dehydrogenase (LDH), 24 -hour urine protein excretion and random urine protein-creatinine ratio. Enzyme-linked immunosorbent assay (ELISAs) for human soluble endoglin, SFlt1, and free PIGF will be conducted in duplicate with the use of commercial kits (R§D Systems). The ratio of SFlt1:PIGF will be calculated. All the participants will be followed up at 3 months and 1 year in which blood pressure, UACR and serum creatinine will be recorded at each visit.

Official Title
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Long Term Renal Outcome in Preeclampsia : Role of sFlt-1 / PlGF and Endoglin

Conditions
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Preeclampsia, Renal Function

Intervention / Treatment
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* Diagnostic Test: Renal function
* Diagnostic Test: proteinuria


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: more than 24 weeks of gestation who were diagnosed and classified as preeclampsia or gestational hypertension by the criteria recommends by the American College of Obstetricians and Gynecologists (ACOG) Severe preeclampsia will be diagnosed by: A systolic/diastolic blood pressure ≥ 140 mmHg occurring on two occasions at least 4 hours apart after 20 weeks of gestation a women whose blood pressure has previously been normal Proteinuria with excretion of 0.3 gm or more of protein in a 24 hour urine specimen or urine dipstick results of at least 1+(30 mg per deciliter) on two occasions Exclusion Criteria: chronic hypertension before pregnancy ,chronic kidney disease according to KDIGO criteria ,twin pregnancies,underlying diabetes mellitus -

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 40 Years

Sexes Eligible for Study
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All

Study Plan
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How is the study designed?
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Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Renal function|measure eGFR at one year post partum|
|Diagnostic Test: proteinuria|measure urine protein creatinine ratio at one year postpartum|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Correlation between serum sFlt-1/PIGF with long term renal function in preeclampsia | measure serum sFlt-1/PIGF and eGFR | 1 year | 
| Correlation between serum sFlt-1/PIGF with level of blood pressure in preeclampsia | measure serum sFlt-1/PIGF and blood pressure | 1 year | 
| Correlation between serum sFlt-1/PIGF with level of proteinuria in preeclampsia | measure serum sFlt-1/PIGF and UACR | 1 year | 
| Correlation between serum endoglin with long term renal function in preeclampsia | measure endoglin and eGFR | 1 year | 
| Correlation between serum endoglin with blood pressure in preeclampsia | measure endoglin and blood pressure | 1 year | 
| Correlation between serum endoglin with level of proteinuria in preeclampsia | measure endoglin and UPCR | 1 year |