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Review
. 2024 Feb 27;25(5):2741.
doi: 10.3390/ijms25052741.

Placental and Renal Pathways Underlying Pre-Eclampsia

Paraskevi Eva Andronikidi  1 , Eirini Orovou  2 , Eleftheria Mavrigiannaki  3 , Virginia Athanasiadou  1 , Maria Tzitiridou-Chatzopoulou  2 , George Iatrakis  4 , Eirini Grapsa  1
Affiliations
Review

Placental and Renal Pathways Underlying Pre-Eclampsia

Paraskevi Eva Andronikidi et al. Int J Mol Sci. .

Abstract

Pre-eclampsia is a serious complication of pregnancy characterized by a state of multiorgan hypertensive disorders, with or without proteinuria and possible multiorgan dysfunction. Chronic kidney disease is an established risk factor for the development of pre-eclampsia, as angiogenic homeostasis is altered and the maternal circulation is already hypertensive. Facing pre-eclampsia in the context of chronic kidney disease is a challenging emergency for both the mother and the fetus. The clinical features and the management of this multi-organ disorder are clearly defined in the modern literature but the underlying pathophysiologic mechanisms remain not fully elucidated. Understanding the pathophysiology that mediates the onset of pre-eclampsia itself and in synergy with chronic kidney disease is fundamental for developing prompt prevention strategies, treatment planning, and patient counseling. This review aims to summarize the main molecular mechanisms involved in the process of pre-eclampsia, with a particular focus on the role of the kidneys and hormonal pathways related to renal function in normal pregnancy and pre-eclamptic syndromes.

Keywords: AKI; CKD; hypertension; kidney; placenta; placentation; pre-eclampsia.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pattern of CTB invasion, normal pregnancy, and PE. EVT: extravillous trophoblast, ENVT: endovascular CTB, and NK cell: natural killer cell.
Figure 2
Figure 2
Renal physiology by trimester of pregnancy. Notes: Arrow ↑ increase, Arrow ↓ decrease.
See this image and copyright information in PMC

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