Urinary congophilia in women with pre-eclampsia and chronic kidney disease

Abstract Background Pre-eclampsia remains a major cause of fetal and maternal morbidity. Researchers have reported that urinary congophilia could be a useful test in the diagnosis and prediction of the disorder. Congophilia is thought to indicate the presence of amyloid protein, an aggregate of misf...

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Bibliographic Details
Published in:The Lancet (British edition) 2016-02, Vol.387, p.S72-S72
Main Authors: McCarthy, Fergus, Dr, Adetoba, Adedamola, BSc, Gill, Carolyn, PhD, Bramham, Kate, PhD, Bertolaccini, Maria, PhD, Girardi, Guillermina, Prof, Poston, Lucilla, Prof, Chappell, Lucy, Prof
Format: Article
Language:English
Subjects:
Autoimmune diseases
Hypertension
Internal Medicine
Kidneys
Renal function
Retention
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Summary:Abstract Background Pre-eclampsia remains a major cause of fetal and maternal morbidity. Researchers have reported that urinary congophilia could be a useful test in the diagnosis and prediction of the disorder. Congophilia is thought to indicate the presence of amyloid protein, an aggregate of misfolded proteins implicated through placental endoplasmic reticulum stress in pre-eclampsia. We aimed to determine whether congophilia is a specific diagnostic test for pre-eclampsia and superimposed pre-eclampsia. Methods We analysed samples from women with pre-eclampsia (n=23), gestational hypertension (10), chronic kidney disease (28), chronic hypertension (14), chronic kidney disease with superimposed pre-eclampsia (5), chronic hypertension with superimposed pre-eclampsia (12), and healthy pregnant controls (31). Samples from healthy non-pregnant controls (n=10) and non-pregnant women with systemic lupus erythematosus either with (25) or without lupus nephritis (14) were analysed. Urinary congophilia was quantified by measurement of congo red retention (CRR) and compared between groups. Findings A significant increase in congophilia was detected in urine from women with pre-eclampsia (median CRR 47%, IQR 22–68) compared with healthy pregnant controls (16, 13–21; p=0·002), women with gestational hypertension (20, 13–27; p=0·008), or women with chronic hypertension (17, 12–28; p=0·01). Congophilia was also present in pregnant women with chronic kidney disease and was not significantly different from those with pre-eclampsia or women with chronic kidney disease and superimposed pre-eclampsia. Non-pregnant women with lupus nephritis had significantly higher congophilia retention than did non-pregnant controls (38%, 17–73 vs 9, 7–11; p
ISSN:0140-6736
1474-547X
DOI:10.1016/S0140-6736(16)00459-1