Abstract
This study describes the levels of urinary-fibrinopeptide A/creatinine (FPA/CRE), fibrin-derived peptide Bα15-42/creatinine (Bα15-42/CRE) and the kallikrein-kinin system in normal pregnancy, labor and puerperium. To understand the roles of u-FPA/CRE, Bα15-42/CRE and the kallikrein-kinin system in the kidney all components of the system and localization need to be considered.
Levels of u-FPA/CRE increased gradually from midterm of pregnancy. U-β15-42/CRE increased from early stage of preg, especially in late stage of pregnancy (FPA/CRE=0.9±0.6ng/mg, Bα15-42/CRE=12.2±3.7ng/mg). Levels of u-FPA/CRE and Bα15-42/CRE in the 2nd stage of labor (FPA/CRE=1.2α0.7ng/mg, Bα15-42/CRE=23.1±15.6ng/mg) were significantly increased when compared to late stage of pregnancy.
These pattern closely resembled that the intrarenal vascular hypercoagulation and hyperfibrinolytic activity and/or the increasing of renal plasma flow (RPF) and glomerular filtration rate (GFR) appeared during pregnancy and labor.
Levels of u-kallikrein activity/CRE and quantity/CRE significantly increased in midterm of pregnancy (u-kallikrein activity/CRE=2.3±0.9ng/min/mg, u-kallikrein quantity/CRE=406.2±217.5ng/mg), but gradually decreased (u-kallikrein activity/CRE=1.0±0.7ng/min/mg, u-kallikrein quantity/CRE=160.3±125.7ng/mg). Levels of u-kallikrein activity/CRE and quantity/CRE in the full term pregnancy and 2nd stage of labor were slightly decreased when compared to non-pregnant women. Levels of u-kinin/CRE during pregnancy markedly increased in 12-16 weeks of pregnancy (u-kinin/CRE=17.5±10.3ng/mg) and gradually decreased from midterm to late stage of pregnancy. Levels of u-kininase activity/CRE and kininase-II quantity/CRE gradually decreased from early stage to midterm pregnancy and slightly increased in late stage of pregnancy, but not significantly. Levels of u-kininase activity/CRE were markedly increased (u-kininase activity/CRE=23.4±12.5pg/min/mg), and u-kininase-II quantity/CRE were decreased (u-kininase-II quantity/CRE=4.4±1.4x10-3IU/min/mg) in the 2nd stage of labor when compared to non-pregnant women.
These findings suggested that availability of renal kallikrein activity and quantity and kininase activity and kininase-II quantity in pregnancy, labor and puerperium were major determinants of levels of kinin in the kidney.
