Glomerular Basement Membrane Changes in African Women with Early-Onset Preeclampsia

Abstract

Objective: An ultrastructural evaluation of heparan sulfate proteoglycan macromolecules in the glomerular basement membrane of African women with early-onset preeclampsia and assessment of the relationship of these anionic sites to the degree of proteinuria in these patients.

Design: Prospective, descriptive study.

Setting: Obstetric wards. King Edward VIII Hospital (KEH), Durban, South Africa, a tertiary referral center serving an underprivileged community.

Subjects: Ten patients with early-onset preeclampsia (i.e., between 24 and 34 weeks of gestation) and five controls from adult trauma patients undergoing partial nephrectomy.

Main Outcome Measure: Quantitative analysis of polyethyleneimine-labeled anionic sites within the glomerular basement membrane (GBM).

Results: There was a significant reduction in labeling within the lamina rara externa of the early-onset preeclampsia (EOPE) group compared to control specimens (P ± 0.02). There was a strong correlation (r = –0.79) between the severity of proteinuria and the loss of anionic sites.

Conclusion: Our findings suggest that proteinuria in early-onset preeclampsia may result from a decreased negative charge at the GBM level.

Key Words:

• changes
• Early-onset preeclampsia
• Glomerular basement membrane