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

IntroductionWomen 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...

Full description

Saved in:
Bibliographic Details
Main Authors: Ashley Griffin, Jamie Szczepanski, Shauna-Kay Spencer, Lucia Solis, Teylor Bowles, Reanna Robinson, Jan M. Williams, Patrick B. Kyle, Kedra Wallace
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-11-01
Series:Frontiers in Physiology
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fphys.2024.1468793/full
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850158976376766464
author Ashley Griffin
Jamie Szczepanski
Shauna-Kay Spencer
Shauna-Kay Spencer
Lucia Solis
Teylor Bowles
Reanna Robinson
Jan M. Williams
Patrick B. Kyle
Kedra Wallace
Kedra Wallace
author_facet Ashley Griffin
Jamie Szczepanski
Shauna-Kay Spencer
Shauna-Kay Spencer
Lucia Solis
Teylor Bowles
Reanna Robinson
Jan M. Williams
Patrick B. Kyle
Kedra Wallace
Kedra Wallace
author_sort Ashley Griffin
collection DOAJ
description IntroductionWomen 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.MethodsUsing 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.ResultsHELLP + 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.ConclusionHELLP + 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.
format Article
id doaj-art-1b5927c60d6046e9a75972764263827d
institution OA Journals
issn 1664-042X
language English
publishDate 2024-11-01
publisher Frontiers Media S.A.
record_format Article
series Frontiers in Physiology
spelling doaj-art-1b5927c60d6046e9a75972764263827d2025-08-20T02:23:44ZengFrontiers Media S.A.Frontiers in Physiology1664-042X2024-11-011510.3389/fphys.2024.14687931468793Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum ratsAshley Griffin0Jamie Szczepanski1Shauna-Kay Spencer2Shauna-Kay Spencer3Lucia Solis4Teylor Bowles5Reanna Robinson6Jan M. Williams7Patrick B. Kyle8Kedra Wallace9Kedra Wallace10Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Pathology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United StatesDepartment of Pharmacology & Toxicology, University of Mississippi Medical Center, Jackson, MS, United StatesIntroductionWomen 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.MethodsUsing 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.ResultsHELLP + 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.ConclusionHELLP + 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.https://www.frontiersin.org/articles/10.3389/fphys.2024.1468793/fullAKICKDcognitionHELLP syndromememorypostpartum
spellingShingle Ashley Griffin
Jamie Szczepanski
Shauna-Kay Spencer
Shauna-Kay Spencer
Lucia Solis
Teylor Bowles
Reanna Robinson
Jan M. Williams
Patrick B. Kyle
Kedra Wallace
Kedra Wallace
Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
Frontiers in Physiology
AKI
CKD
cognition
HELLP syndrome
memory
postpartum
title Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
title_full Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
title_fullStr Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
title_full_unstemmed Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
title_short Pregnancy-related acute kidney injury leads to hypertension, reduced kidney function and cognitive impairment in postpartum rats
title_sort pregnancy related acute kidney injury leads to hypertension reduced kidney function and cognitive impairment in postpartum rats
topic AKI
CKD
cognition
HELLP syndrome
memory
postpartum
url https://www.frontiersin.org/articles/10.3389/fphys.2024.1468793/full
work_keys_str_mv AT ashleygriffin pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT jamieszczepanski pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT shaunakayspencer pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT shaunakayspencer pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT luciasolis pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT teylorbowles pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT reannarobinson pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT janmwilliams pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT patrickbkyle pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT kedrawallace pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats
AT kedrawallace pregnancyrelatedacutekidneyinjuryleadstohypertensionreducedkidneyfunctionandcognitiveimpairmentinpostpartumrats