Abstract Preeclampsia, affecting 5-8% of pregnancies, is the main cause of fetal-maternal mortality and morbidity. The differential diagnosis with chronic kidney disease (CKD) is a challenge owing to the overlapping clinical features. No biomarker has been found to discriminate between the two conditions. Here, we tested whether maternal serum levels of placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1), markers of preeclampsia, could be used to discriminate between 34 patients with preeclampsia, 23 patients with CKD during pregnancy, and 38 healthy pregnant women. Serum levels of PlGF and sFlt-1 were determined during the third trimester by commercially available immunoassays. In preeclampsia, sFlt-1 levels were significantly increased in comparison with that in CKD and in the control women. Serum levels of PlGF in preeclampsia were significantly decreased relative to both controls and patients with CKD. The sFlt-1 to PlGF ratio was significantly increased in preeclampsia (median 436) compared with controls (median 9.4) and CKD (median 4.0). No differences were found between controls and patients with CKD. Thus, our study suggests that it is possible to discriminate between preeclampsia and CKD during pregnancy by determining maternal serum levels of sFlt-1 and PlGF and their ratio.Kidney International advance online publication, 26 September 2012; doi:10.1038/ki.2012.348.

Chronic kidney disease may be differentially diagnosed from preeclampsia by serum biomarkers

ROLFO, Alessandro;ATTINI, ROSSELLA;NUZZO, ANNA MARIA;PIAZZESE, Annalisa;PARISI, Silvia;FERRARESI, Martina;TODROS, Tullia;PICCOLI, Giorgina Barbara
2013-01-01

Abstract

Abstract Preeclampsia, affecting 5-8% of pregnancies, is the main cause of fetal-maternal mortality and morbidity. The differential diagnosis with chronic kidney disease (CKD) is a challenge owing to the overlapping clinical features. No biomarker has been found to discriminate between the two conditions. Here, we tested whether maternal serum levels of placental growth factor (PlGF) and soluble FMS-like tyrosine kinase-1 (sFlt-1), markers of preeclampsia, could be used to discriminate between 34 patients with preeclampsia, 23 patients with CKD during pregnancy, and 38 healthy pregnant women. Serum levels of PlGF and sFlt-1 were determined during the third trimester by commercially available immunoassays. In preeclampsia, sFlt-1 levels were significantly increased in comparison with that in CKD and in the control women. Serum levels of PlGF in preeclampsia were significantly decreased relative to both controls and patients with CKD. The sFlt-1 to PlGF ratio was significantly increased in preeclampsia (median 436) compared with controls (median 9.4) and CKD (median 4.0). No differences were found between controls and patients with CKD. Thus, our study suggests that it is possible to discriminate between preeclampsia and CKD during pregnancy by determining maternal serum levels of sFlt-1 and PlGF and their ratio.Kidney International advance online publication, 26 September 2012; doi:10.1038/ki.2012.348.
2013
83
1
177
181
CKD; preeclampsia; differential diagnosis; pregnacy
Alessandro Rolfo; Rossella Attini; Anna M. Nuzzo; Annalisa Piazzese; Silvia Parisi; Martina Ferraresi; Tullia Todros; Giorgina B Piccoli
File in questo prodotto:
File Dimensione Formato  
Kidney_int_rolfo_2013.pdf

Accesso riservato

Tipo di file: PDF EDITORIALE
Dimensione 226.11 kB
Formato Adobe PDF
226.11 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Kidney International_2013_Rolfo_et_al_post_print_4aperto.pdf

Accesso aperto

Tipo di file: POSTPRINT (VERSIONE FINALE DELL’AUTORE)
Dimensione 466.25 kB
Formato Adobe PDF
466.25 kB Adobe PDF Visualizza/Apri

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/125518
Citazioni
  • ???jsp.display-item.citation.pmc??? 41
  • Scopus 110
  • ???jsp.display-item.citation.isi??? 93
social impact