Kidney Week

Abstract: FR-PO0975

Kidney Tubular Function Markers and Risk of Hypertensive Disorders in Pregnancy

Session Information

• Women's Health and Kidney Diseases
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Wong, Angela, University of California San Diego, La Jolla, California, United States

Angela Wong

• Rifkin, Dena E., University of California San Diego, La Jolla, California, United States

Dena E. Rifkin, MD

• Bullen, Alexander L., University of California San Diego, La Jolla, California, United States

Alexander L. Bullen, MD, FASN

Background

Hypertensive disorders in pregnancy (HDP) are a leading cause of maternal and fetal morbidity and mortality worldwide. Recently, uromodulin, a tubular marker of kidney reserve, was linked to chronic hypertension in pregnant rats. We have previously shown that uromodulin and other tubular markers are associated with increased risk of kidney and cardiovascular outcomes across diverse populations. This pilot study aimed to evaluate the association between tubular markers and HDP.

Methods

We identified 25 women (5 cases and 20 controls) with gestational ages less than 20 weeks who were seen at UC San Diego. We measured uromodulin (tubular reserve), epidermal growth factor (tubular repair), and alpha-1 microglobulin (tubular reabsorption). Given skewed distributions, we log-base-2 transformed each biomarker to facilitate interpretation of parameter estimates as per a two-fold higher level of each biomarker. We then performed Firth-penalized logistic regression. To assess functional associations, we also evaluated the biomarkers by tertiles.

Results

In Firth-penalized logistic regression, both EGF and a1m were associated with higher odds of HDP; however, the confidence intervals were wide (Graph). Compared with participants in the lowest EGF tertile, those in the highest tertile had approximately 4- to 5-fold higher odds of HDP. Uromodulin was not associated with hypertension.

Conclusion

In this exploratory analysis, tubular function markers demonstrated heterogeneous associations with HDP, with EGF and a1m showing the most consistent signal. Overall suggesting that alterations in tubular health are involved in the pathophysiology of HDP. Larger, well-powered studies with longitudinal sampling are needed to evaluate these associations.

Funding

• NIDDK Support