Placental and endothelial biomarkers for the prediction of superimposed pre-eclampsia in chronic kidney disease

• DOI: 10.1016/j.preghy.2021.02.010
• Publication Date: 2021-02-23T08:29:22Z
• Authors: Kate Wiles; Kate Bramham; Paul T. Seed; Anna Brockbank; Catherine Nelson-...; S. Ananth Karumanchi; Liz Lightstone; Lucy C. Chappell
• Keywords: Adult; Placenta; 610; Vascular Cell Adhesion Molecule-1; sFlt-1; Gestational Age; 03 medical and health sciences; 0302 clinical medicine; Pre-Eclampsia; Pregnancy; VCAM; Humans; Prospective Studies; Hyaluronic Acid; Renal Insufficiency, Chronic; Hyaluronan; Placenta Growth Factor; Vascular Endothelial Growth Factor Receptor-1; Chronic renal insufficiency; 3. Good health; PlGF; Female; Pre-eclampsia; Biomarkers

Abstract Objectives To evaluate PlGF, sFlt-1, and novel endothelial biomarkers hyaluronan vascular cell adhesion molecule (VCAM), for the prediction of superimposed pre-eclampsia in women with chronic kidney disease (CKD). Study design Prospective cohort study pregnant CKD UK. Main outcome measures Outcomes including were based on predetermined criteria. Test performances plasma serum sFlt-1:PlGF, VCAM concentrations evaluated as area under receiver-operating curve at established exploratory threshold concentrations. Results There 232 pregnancies 221 CKD. One third (76/232) developed pre-eclampsia. From 21 to 37 weeks’ gestation, PlGF was decreased among that preeclampsia. Plasma levels 38 did not usefully predict need deliver when measured serum. Conclusions Increased surveillance delivery should take place below 150 pg/ml after 20 weeks’ awareness predictive value is reduced excretory function declines. Maternal dysfunction may alter which manifests