A 30-year-old primigravid woman in the 31st week of pregnancy complains of severe swelling in her calves and ankles. Physical exam reveals moderate edema of the lower extremities, a common complaint during the 3rd trimester of pregnancy. Blood pressure is 142/91; urine dipstick is positive (2+) for protein. Which of the following renal parameters is most likely reduced in this patient?
(check all that apply)
A. Capillary flow B. Endothelin 1 C. Glomerular Filtration Rate D. Vascular Endothelial Growth Factor (VEGF)
Capillary flow-2. glomerular filtration rate-this woman has preeclampsia. reduced gfr, and alterations in the vascularendothelium of the kidneys, are the primary reasons behind the increased proteinuria.explanations:1) renal capillary blood flow and gfr decrease in women with preeclampsia, due to the increasedlevels of locally-acting vasoconstrictors.2) endothelin (a potent vasoconstrictor) levels increase, and are a major cause of thevasoconstriction of the renal capillary bed.3) in response to the vasoconstriction and reduced flow, levels of vegf actually increase. however,recall that the soluble vegf receptor (sflt) increases, and binds much of the vegf, thereby notpermitting vegf to initiate new angiogenesis.