Skip to main content

ORIGINAL RESEARCH article

Front. Physiol.
Sec. Clinical and Translational Physiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1468793

Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats

Provisionally accepted
Ashley Griffin Ashley Griffin Jamie Szczepanski Jamie Szczepanski Shauna Spencer Shauna Spencer Lucia Solis Lucia Solis Teylor Bowles Teylor Bowles Reanna Robinson Reanna Robinson Jan Michael Williams Jan Michael Williams Patrick Kyle Patrick Kyle Kedra Wallace Kedra Wallace *
  • University of Mississippi Medical Center, Jackson, United States

The final, formatted version of the article will be published soon.

    Women with hypertensive disorders of pregnancy such as HELLP (hemolysis, elevated liver enzyme, low platelet) Syndrome are affected by acute kidney injury during pregnancy (PR-AKI) at higher rates than women without hypertension. Both hypertensive disorders of pregnancy and acute Kidney Injury (AKI) outside the context of pregnancy have been associated with an increased risk of developing chronic kidney disease (CKD) and cognitive impairment. In our current study, we set out to determine if PR-AKI led to the development of CKD and impaired cognition in the postpartum period and if HELLP syndrome exacerbates the impairments. Methods. Using timed-pregnant Sprague Dawley rats, on gestational day (GD) 12, mini-osmotic pumps infusing anti-angiogenic factors were surgically placed in the intraperitoneal cavity to induce HELLP. On GD18, AKI was induced via bilateral renal reperfusion ischemia surgery. Mean arterial pressure and birth outcomes were used to assess the global effects of AKI, and liver enzymes were used to assess HELLP. CKD was assessed by measuring glomerular filtration rate (GFR), urinary output, and renal fibrosis. Anxiety-like behaviors, object recognition memory, spatial memory, and avoidance memory were assessed via behavioral experiments. Results. HELLP+AKI rats demonstrated more evidence of renal injury, hypertension, and behavioral deficits compared to normal pregnant animals. In addition, AKI had a negative impact on birth outcomes and maternal survival. Conclusion. HELLP+AKI together led to evidence of persistent hypertension, progressive renal dysfunction, and cognitive impairment, which were exacerbated compared to AKI or HELLP alone. These findings suggest that PR-AKI in the presence of a hypertensive disorder of pregnancy, such as HELLP, leads to the development of CKD, cognitive dysfunction, and hypertension.

    Keywords: AKI, CKD, Cognition, HELLP Syndrome, Memory, Postpartum, Pregnancy, renal injury

    Received: 22 Jul 2024; Accepted: 12 Nov 2024.

    Copyright: © 2024 Griffin, Szczepanski, Spencer, Solis, Bowles, Robinson, Williams, Kyle and Wallace. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Kedra Wallace, University of Mississippi Medical Center, Jackson, United States

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.