From preeclampsia to renal disease
| PhD ceremony: | Ms A.M. (Anne Marijn) van der Graaf-Hilbers |
| When: | January 27, 2016 |
| Start: | 16:15 |
| Supervisors: | G.J. (Gerjan) Navis, prof. dr. S.A. Scherjon |
| Co-supervisors: | dr. M.M. (Marijke) Faas, dr. A.T. Lely |
| Where: | Academy building RUG / Student Information & Administration |
| Faculty: | Medical Sciences / UMCG |
Formerly preeclamptic women are more susceptible to renal disease later in life as compared to women following a healthy pregnancy. Whether it is preeclampsia per se or shared risk factors for preeclampsia and renal disease inducing this increased risk is unknown. Also the mechanisms behind this increased susceptibility remain unknown.
We hypothesized that increased angiotensin II (ang II) sensitivity and endothelial dysfunction are involved. We first validated a rat model for preeclampsia for these features assumed to be involved in the late complications of preeclampsia, and second, we performed postpartum studies in formerly preeclamptic women and formerly preeclamptic rats. We assessed whether disturbances seen during preeclampsia, i.e. altered renal hemodynamics, increased ang II sensitivity, and endothelial dysfunction, persisted postpartum in order to elucidate whether these mechanisms might be involved in the increased susceptibility to renal disease. Elucidating these mechanisms gained insight into why formerly preeclamptic women are more susceptible for renal disease, which is an important step towards follow-up and preventive treatment of these women.
We demonstrated long-term consequences of preeclampsia. Our studies point toward a role for preeclampsia on the postpartum impairments in women with a history of preeclampsia, thereby increasing the susceptibility of these women to develop renal disease later in life. Postpartum renal hemodynamics, persistent increased ang II sensitivity, endothelial dysfunction, and arterial stiffness all provide leads for further research into the exact mechanisms behind this increased susceptibility. Using a history of preeclampsia as an early marker to identify young women at risk for premature cardiovascular and renal disease opens a window of opportunities for preventive treatment in this specific group of women, even in the absence of known cardiovascular risk factors.