Past Kidney Disease May Increase Preeclampsia Risk, Impair Blood Vessel Health during Pregnancy

Know your kidney history before getting pregnant, researchers suggest 

(Charlottesville, Va.) June 27, 2022—A history of kidney problems may put people at a higher risk for impaired blood vessel function, which could lead to high blood pressure, preterm labor and other adverse outcomes, according to the results of a study in rats. The researchers will present their work this week at the American Physiological Society (APS) and American Society for Nephrology Control of Renal Function in Health and Disease conference in Charlottesville, Virginia.  

“Our preclinical evidence indicates that history of an [acute kidney injury] should be considered a risk factor contributing to prenatal care regimens.” —Desmond Moronge, RPh 

Acute kidney injury (AKI) is a sudden loss of kidney function that can occur for a wide range of reasons, including excessive fluid loss from diarrhea or vomiting, kidney stones, antibiotic use, cancer treatment and congestive heart failure. Complications during pregnancy, including postpartum hemorrhaging, can lead to AKI. 

During a healthy pregnancy, the vascular system adapts to handle the increased blood flow that occurs. The blood vessels are able to dilate more and reduce blood pressure. Endothelial dysfunction—an impairment of the innermost layer of cells that line the blood vessels—contributes to high blood pressure in pregnancy, a condition called preeclampsia. The kidneys also adapt during pregnancy to help filter the additional blood volume. But in people who are pregnant and have had prior AKI or a history of kidney disease, the kidneys may not be able to handle the additional stress. This inability to adapt may also increase the risk of preeclampsia and preterm labor. 

Researchers from Augusta University in Georgia studied a rat model of post-AKI pregnancy. They found that kidney injury prior to pregnancy—even after a full recovery—caused higher levels of kidney inflammation, impaired endothelial function and dysregulation of the renin angiotensin system, a hormone system that regulates blood pressure. 

“Prior kidney disease history results in a form of subclinical injury that remains masked, but upon pregnancy as a second stressor, the complications start to be revealed. Therefore, it is important for people to know their baseline kidney function as well as past kidney function history before getting pregnant and even during pregnancy,” said Desmond Moronge, RPh, first author of the study. “Our preclinical evidence indicates that history of an AKI should be considered a risk factor contributing to prenatal care regimens.” 

Funding for this conference was made possible, in part, by 1 R13 DK132924-01 from the National Institute of Diabetes and Digestive and Kidney Diseases. The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention by trade names, commercial practices or organizations imply endorsement by the U.S. Government.   

NOTE TO JOURNALISTS: The Control of Renal Function in Health and Disease conference will be held June 26–30 in Charlottesville, Virginia. To schedule an interview with the researchers, conference organizers or presenters, contact APS Media Relations or call 301.634.7314. Find more highlights in our Newsroom.  

Physiology is a broad area of scientific inquiry that focuses on how molecules, cells, tissues and organs function in health and disease. The American Physiological Society connects a global, multidisciplinary community of more than 10,000 biomedical scientists and educators as part of its mission to advance scientific discovery, understand life and improve health. The Society drives collaboration and spotlights scientific discoveries through its 16 scholarly journals and programming that support researchers and educators in their work.