Can preeclampsia be considered a renal compartment syndrome? A hypothesis and analysis of the literature.
J Am Soc Hypertens
; 10(11): 891-899, 2016 11.
Article
en En
| MEDLINE
| ID: mdl-27751879
The morbidity and mortality associated with preeclampsia is staggering. The physiology of the Page kidney, a condition in which increased intrarenal pressure causes hypertension, appears to provide a unifying framework to explain the complex pathophysiology. Page kidney hypertension is renin-mediated acutely and ischemia-mediated chronically. Renal venous outflow obstruction also causes a Page kidney phenomenon, providing a hypothesis for the increased vulnerability of a subset of women who have what we are hypothesizing is a "renal compartment syndrome" due to inadequate ipsilateral collateral renal venous circulation consistent with well-known variation in normal venous anatomy. Dynamic changes in renal venous anatomy and physiology in pregnancy appear to correlate with disease onset, severity, and recurrence. Since maternal recumbent position is well known to affect renal perfusion and since chronic outflow obstruction makes women vulnerable to the ischemic/inflammatory sequelae, heightened awareness of renal compartment syndrome physiology is critical. The anatomic and physiologic insights provide immediate strategies to predict and prevent preeclampsia with straightforward, low-cost interventions that make renewed global advocacy for pregnant women a realistic goal.
Palabras clave
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Preeclampsia
/
Circulación Renal
/
Venas Renales
/
Renina
/
Síndromes Compartimentales
/
Riñón
Tipo de estudio:
Etiology_studies
/
Prognostic_studies
Límite:
Female
/
Humans
/
Pregnancy
Idioma:
En
Revista:
J Am Soc Hypertens
Asunto de la revista:
ANGIOLOGIA
/
CARDIOLOGIA
Año:
2016
Tipo del documento:
Article