Podocytes in urine, a novel biomarker of preeclampsia?

Preeclampsia is a disorder occurring during pregnancy typically after 20 weeks of gestation. It affects both mother and unborn baby in at least 5-8% of all pregnancies. It is a rapidly progressive condition characterized by high blood pressure and the presence of protein in the urine. The symptoms, such as swelling, sudden weight gain, headaches and vision disturbances, are important signs of preeclampsia which can lead to maternal and infant illness and death. It is estimated that this disorder is responsible for 76,000 maternal and 500,000 infant deaths each year. The main hypothesis explaining the development of preeclampsia is the theory of placental hypoxia/ischemia. An imbalance between vascular endothelial growth factor (VEGF) and soluble fms-like tyro-sine kinase-1 (sFlt-1) seems to play a crucial role. Currently there is no way to predict, with certainty whether preeclampsia will develop during a given pregnancy. There is a need for a diagnostic tool which can help to identify and monitor women at risk. There is growing evidence that podocyturia - urinary excretion of viable podocytes may be a useful predictor of preeclampsia. This paper presents facts supporting such a hypothesis.