GLOMERULAR-BASEMENT-MEMBRANE CHANGES IN AFRICAN WOMEN WITH EARLY-ONSET PREECLAMPSIA

Objective: An ultrastructural evaluation of heparan sulfate proteoglyc an macromolecules in the glomerular basement membrane of African women with early-onset preeclampsia and assessment of the relationship of t hese anionic sites to the degree of proteinuria in these patients. Des ign: Prospective, descriptive study. Setting: Obstetric wards, King Ed ward VIII Hospital (KEH), Durban, South Africa, a tertiary referral ce nter 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 nephr ectomy. Main Outcome Measure: Quantitative analysis of polyethyleneimi ne-labeled anionic sites within the glomerular basement membrane (GEM) . Results: There was a significant reduction in labeling within the la mina rara externa of the early-onset preeclampsia (EOPE) group compare d to control specimens (P less than or equal to 0.02). There was a str ong correlation (r = -0.79) between the severity of proteinuria and th e loss of anionic sites. Conclusion: Our findings suggest that protein uria in early-onset preeclampsia may result from a decreased negative charge at the GEM level.