Difficulty of predicting early-onset super-imposed preeclampsia in pregnant women with hemodialysis due to diabetic nephropathy by serum levels of sFlt-1, PlGF, and sEng.

Content Provider	Europe PMC
Author	Morisawa, Hiroyuki Hirashima, Chikako Sano, Miho Nagayama, Shiho Takahashi, Hironori Shirasuna, Koumei Ohkuchi, Akihide
Abstract	There are few case reports in which circulating levels of soluble fms-like tyrosine kinase 1 (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng) were measured before the onset of super-imposed preeclampsia in women with hemodialysis. A 40-year-old Japanese nulliparous women with hemodialysis due to diabetic nephropathy became pregnant by frozen embryo transfer. Intensive hemodialysis was started at 5 weeks of gestation. Her blood pressure (BP) in the first trimester was around 130/80 mmHg. At 20+3 weeks, she was admitted for close monitoring; her BP was 137/75 mmHg. Her BP increased to 157/88 mmHg at 31+2 weeks, and nifedipine at 20 mg/day was started at 31+6 weeks. However, the serial longitudinal measurements of sFlt-1, PlGF, and sEng did not predict the onset of super-imposed preeclampsia. Cesarean section was performed at 33+6 weeks due to uncontrollable hypertension. A healthy female infant weighing 2138 g was delivered. As for the changes of biomarkers between just before and just after hemodialysis, sFlt-1 was significantly higher just after compared with just before hemodialysis (5774 ± 1875 pg/mL vs. 2960 ± 905 pg/mL, respectively, p < 0.001). PlGF was also significantly higher just after compared with just before hemodialysis (2227 ± 1038 pg/mL vs. 1377 ± 614 pg/mL, respectively, p < 0.001). However, the sFlt-1/PlGF ratio and sEng levels were not significantly different between just before and just after hemodialysis (p = 0.115, p = 0.672, respectively). In conclusion, prediction of early-onset super-imposed preeclampsia using angiogenic and anti-angiogenic markers in pregnant women with hemodialysis might be difficult.
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Volume Number	9
DOI	10.1007/s13730-019-00435-y
PubMed Central reference number	PMC7148397
Issue Number	2
PubMed reference number	31728843
Journal	CEN Case Reports [CEN Case Rep]
e-ISSN	21924449
Language	English
Publisher	Springer Singapore
Publisher Date	2019-11-14
Publisher Place	Singapore
Access Restriction	Open
Rights License	© Japanese Society of Nephrology 2019
Subject Keyword	Hemodialysis Soluble fms-like tyrosine kinase 1 Soluble endoglin Placental growth factor Preeclampsia
Content Type	Text
Resource Type	Article
Subject	Nephrology