Prognostic value of Human epididymis protein 4 (HE4) for persistent proteinuria in women with severe preeclampsia / HELLP syndrome

Abstract

reeclampsia is a multisystem disorder that has substantial adverse effects for pregnant women and their fetuses, and it is a major cause of maternal morbidity and mortality worldwide, that complicates 4.6 % of pregnancies globally and can reach up to 10 % of pregnancies in the developing world, mainly due to the lack of health care facilities. Preeclampsia affects kidney function during pregnancy causing pregnancy-related (AKI) in approximately 2% of women with severe preeclampsia and also increases the risk of future chronic kidney disease (CKD) and cardiovascular disease. Proteinuria after preeclampsia significantly resolves within three months after delivery. However in some cases, up to 14 % will have persistent proteinuria twelve weeks after delivery, which requires prompt close follow-up and appropriate referral, for underlying renal disease. Because of the health hazards of persistent proteinuria after preeclampsia, its prediction and detection is an important step in the follow-up of kidney functions in women with preeclampsia especially after 3 months of delivery as it is the time for early diagnosis of CKD according to KIDIGO, 2012. Despite the importance of follow-up of kidney functions after preeclampsia the actual postpartum follow-up rates are poor, so there is a need for reliable, simple markers that can predict the effect of severe preeclampsia / HELLP syndrome and future kidney disease.