Podocyturia predates proteinuria and clinical features of preeclampsia:
longitudinal prospective study
#MMPMID23529165
Craici IM
; Wagner SJ
; Bailey KR
; Fitz-Gibbon PD
; Wood-Wentz CM
; Turner ST
; Hayman SR
; White WM
; Brost BC
; Rose CH
; Grande JP
; Garovic VD
Hypertension
2013[Jun]; 61
(6
): 1289-96
PMID23529165
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Podocyturia, the shedding of live podocytes, is present at delivery in women with
preeclampsia. The aim of this study was to test whether podocyturia is present
earlier in pregnancy and predicts for preeclampsia. We also aimed to compare test
characteristics of podocyturia with those of angiogenic factors previously
implicated in the pathogenesis of this disorder. We prospectively enrolled 315
women who provided blood and urine samples at the end of the second trimesters of
their pregnancies (median, 27 gestational weeks) and within 24 hours of their
deliveries (median, 39.5 gestational weeks). Blood samples were analyzed for
angiogenic markers, including placental growth factor, the soluble receptor
fms-like tyrosine kinase receptor-1 for vascular endothelial growth factor, and
endoglin. The urine sediments were analyzed for podocytes, identified by staining
for podocin after culturing the urinary sediments for 24 hours. This analysis
included all women who developed preeclampsia (n=15), gestational hypertension
(n=15), and a subsample of women who remained normotensive throughout pregnancy
(n=44), matched for maternal age and number of previous pregnancies to those who
developed preeclampsia. At the second trimester collection, all women who
developed preeclampsia had podocyturia, compared with none of those who remained
normotensive or were diagnosed with gestational hypertension. Podocyturia in the
second trimester had a significantly greater sensitivity and specificity for the
subsequent diagnosis of preeclampsia than any single angiogenic marker or a
combination thereof. Screening for podocyturia at the end of the second trimester
may allow for accurate identification of pregnant women at risk for preeclampsia.
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