Contribution of dysfunction of maternal hemodynamics to renal impairment in preeclampsia

Abstract

Aims: To investigate the contribution of dysfunction of maternal hemodynamics to renal impairment in preeclampsia (PE).

Methods: Urinary protein excretion, serum creatinine, blood urea nitrogen, uric acid, and glomerular filtration rate were assessed in 571 pregnant women with PE in addition to and noninvasive hemodynamic monitoring. Patients were classified into two groups: PE with renal impairment (glomerular filtration rate <90 ml/min/1.73 m², n = 161) and PE with normal renal function (n = 410). Cut-off values for hemodynamic parameters were calculated using receiver-operating characteristic curve analysis.

Results: Maternal systolic function and cardiac output parameters were low and peripheral resistance was high in the PE renal impairment group. Cut-off values for the hemodynamic parameters, cardiac index, cardiac output, systemic vascular resistance index, and systemic vascular resistance were 2.85 l/min/m², 5.25 l/min, 3,014.5 dyn s cm⁻⁵ m² and 1,636.0 dyn s cm⁻⁵, respectively, according to receiver-operating characteristics curves.

Conclusion: Renal impairment in PE is associated with reduced maternal cardiac output and increased peripheral resistance.