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NDT Advance Access originally published online on March 3, 2009
Nephrology Dialysis Transplantation 2009 24(6):1712-1714; doi:10.1093/ndt/gfp093
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© The Author [2009]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org


Aldosterone, maternal volume status and healthy pregnancies: a cycle of differing views

Marshall D. Lindheimer1 and Phyllis August2

1 Departments of Medicine and Obstetrics & Gynecology, The Pritzker School of Medicine, University of Chicago, Chicago, IL 2 Departments of Medicine and Obstetrics & Gynecology, Weill Medical College of Cornell University, and the Lang Research Center, New York Hospital Queens, New York, NY, USA

Correspondence and offprint requests to: Marshall D. Lindheimer; E-mail: mlindhei@medicine.bsd.uchicago.edu

Keywords: aldosterone; aldosterone synthase; fetal outcome; preeclampsia; pregnancy

The first 150 words of the full text of this article appear below.

In this month's issue, Escher et al. [1] suggest that high aldosterone availability during pregnancy, measured as urinary tetra-aldosterone excretion, is associated with lower maternal blood pressure and larger, healthier neonates. The findings are preliminary with more studies required to confirm these authors’ suggestions, but of interest is that these data extend recent observations by this same group that recall past passionate debates concerning the volume status of normal gravidas and those developing preeclampsia. Also, the roles of the renin–angiotensin–aldosterone system (RAS), previously given short-shrift in discussions concerning preeclampsia's pathogenesis and pathophysiology, have been resurrected by Escher et al.'s current observations and their previous publications, as well [1–4].

All agree that normal pregnancy is characterized by an absolute increment in both extracellular and intravascular volume (by some 6–7 L, at that), but investigators disagree on the meaning of these changes. For some (‘under-fill’ theory) . . . [Full Text of this Article]


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