Renal Injury and Blood Pressure persists into the postpartum period in rats with Severe Preeclampsia/HELLP Syndrome and Acute Kidney Injury during Pregnancy
Ashley Griffin1, Jamie Szczepanski2, Shauna-kay Spencer2, Jan Michael Williams3, Kedra Wallace2
1Delta State University, Mississippi INBRE Research Scholar, Cleveland, MS
2Ob/Gyn, University of Mississippi Medical Center, Jackson, MS
3Pharmacology, University of Mississippi Medical Center, Jackson, MS
Women with HELLP syndrome are more likely to develop acute kidney injury (AKI) compared to women without HELLP. AKI during pregnancy is associated with rates of maternal mortality and fetal loss that range from 30-60%. New data indicates that in addition to an increase in cardiovascular events such as increased blood pressure, women with a history of HELLP are also reported to have higher incidences of chronic kidney disease and end stage renal failure compared to women with histories of normal pregnancies. We tested the hypothesis that rats with sPE/HELLP+AKI during pregnancy would have more severe renal injury compared to NP and NP+AKI rats. There was a significant difference (p<0.0001) in pup weight between NP, HELLP and NP+AKI pups; none of the HELLP+AKI dams delivered any live pups. HELLP rats had a significantly higher plasma creatinine (pCr) level compared to NP rats (1+0.06 vs 1.8+0.3; P=0.05). When rats were subjected to AKI surgery, pCr significantly increased in NP+AKI (2.9+0.4; P=0.03) and in HP+AKI (3.8 +0.3; P=0.01) relative to NP and HELLP control rats. Mean arterial pressure was found to be significantly different among the groups with all groups being significantly increased relative to NP rats (100.5+1.32mmHg) and each other (P<0.01) with the exception of HELLP vs NP+AKI rats which were not significantly different when compared to each other (121+3.5 vs 119.3+2.2mmHg; P=0.71).Studies are currently being conducted in our lab to determine the full extent of oxidative stress, inflammation and progression to chronic kidney disease. These results suggest that the cardiovascular and renal affects that occur during the post-partum period in response to HELLP and/or AKI may occur through different physiological mechanisms.