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- W3023470089 abstract "This chapter discusses the profound alterations in renal hemodynamics and glomerular filtration of normal pregnancy and the changes that occur with preeclampsia. Also discussed are the changes in osmoregulation during gestation, which result from a decreased osmotic threshold for both thirst and vasopressin secretion leading to water retention and dilution of body fluids. Both glomerular filtration (GFR) and renal plasma flow (RPF) rise starting in the luteal phase of the last menstrual cycle, reaching their highest levels (40–65% for GFR and 50–85% for RPF) by at least mid-gestation. The chapter further discusses the possible causes of these changes, emphasizing the potential role for the ovarian hormone relaxin and nitric oxide. As for the decrease in the osmotic thresholds of thirst and vasopressin release during normal gestation, a new steady state of plasma osmolality is reached some 10 mOsm/kg H2O below nonpregnant values, which is maintained till term and manifested by a “normal” plasma sodium concentration of 5 mEq/L or so below nonpregnant norms. These changes too begin in the luteal phase and may relate to increased relaxin secretion. Finally, the physiological changes in the renal handling of uric acid and protein during normal pregnancy, and how they change with preeclampsia are also presented. Both GFR and RPF decrease with preeclampsia but values are still often above nonpregnant levels. Preeclampsia is also characterized by decreased excretion of uric acid leading to hyperuricemia, and changes in renal morphology (glomerular endotheliosis) accompanied by increased urinary protein excretion. The possible roles of antiangiogenic and other circulating factors which may impair glomerular function and structure during preeclampsia are discussed. Finally there are descriptions of preeclampsia’s renal histopathology, as well as indications and contraindications for renal biopsy in pregnant women." @default.
- W3023470089 created "2020-05-13" @default.
- W3023470089 creator A5046765991 @default.
- W3023470089 creator A5075962296 @default.
- W3023470089 creator A5082749921 @default.
- W3023470089 date "2015-01-01" @default.
- W3023470089 modified "2023-10-17" @default.
- W3023470089 title "The Kidney in Normal Pregnancy and Preeclampsia" @default.
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