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Title: | Increased Intra-Abdominal Pressure During Laparoscopic Pneumoperitoneum Enhances Albuminuria via Renal Venous Congestion, Illustrating Pathophysiological Aspects of High Output Preeclampsia | Authors: | DREESEN, Pauline SCHOUTTETEN, Melanie Vande Velde, Nele Kaminski, Iris HEYLEN, Line DE MOOR, Bart Malbrain, Manu L. N. G. GYSELAERS, Wilfried |
Issue Date: | 2020 | Publisher: | MDPI | Source: | Journal of Clinical Medicine, 9 (2) (Art N° 487) | Abstract: | Intra-abdominal hypertension (IAH) causes severe organ dysfunction. Our aim is to evaluate the effect of increased intra-abdominal pressure (IAP) on renal function, hypothesizing that venous congestion may increase proteinuria and fluid retention without endothelial dysfunction. Three urine samples were collected from 32 non-pregnant women undergoing laparoscopic-assisted vaginal hysterectomy (LAVH) and from 10 controls placed in Trendelenburg position for 60 min. Urine sampling was done before (PRE), during or immediately after (PER), and two hours after (POST) the procedure. Urinary albumin, protein and creatinine concentrations were measured in each sample, and ratios were calculated and compared within and between groups. During LAVH, the albumin/creatinine ratio (ACR) increased and persisted POST-procedure, which was not observed in controls. A positive correlation existed between the LAVH duration and the relative change in both ACR and protein/creatinine ratio (PCR) PER- and POST-procedure. Iatrogenic IAH increases urinary ACR and PCR in non-pregnant women via a process of venous congestion. This mechanism might explain the presentation of one specific subtype of late-onset preeclampsia, where no drop of maternal cardiac output is observed. | Notes: | Gyselaers, W (reprint author), UHasselt Hasselt Univ, Fac Med & Life Sci, Dept Physiol, Limburg Clin Res Ctr, B-3590 Diepenbeek, Belgium.; Gyselaers, W (reprint author), Ziekenhuis Oost Limburg, Dept Obstet & Gynecol, B-3600 Genk, Belgium. pauline.dreesen@zol.be; melanie.schoutteten@uhasselt.be; nele.vandevelde@uzleuven.be; iris.kaminski@hotmail.com; line.heylen@zol.be; bart.demoor@jessazh.be; Manu.Malbrain@uzbrussel.be; Wilfried.gyselaers@uhasselt.be |
Other: | Gyselaers, W (reprint author), UHasselt Hasselt Univ, Fac Med & Life Sci, Dept Physiol, Limburg Clin Res Ctr, B-3590 Diepenbeek, Belgium; Ziekenhuis Oost Limburg, Dept Obstet & Gynecol, B-3600 Genk, Belgium. pauline.dreesen@zol.be; melanie.schoutteten@uhasselt.be; nele.vandevelde@uzleuven.be; iris.kaminski@hotmail.com; line.heylen@zol.be; bart.demoor@jessazh.be; Manu.Malbrain@uzbrussel.be; Wilfried.gyselaers@uhasselt.be | Keywords: | Intra-abdominal pressure;preeclampsia;proteinuria;venous congestion | Document URI: | http://hdl.handle.net/1942/30897 | e-ISSN: | 2077-0383 | DOI: | 10.3390/jcm9020487 | ISI #: | WOS:000518823000199 | Rights: | 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open accessarticle distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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dreesen.pdf | Published version | 1.7 MB | Adobe PDF | View/Open |
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