The Kidney Foundation of Canada

Dr. Anne-Marie Côté 

Dr. Anne-Marie Côté 

Université de Sherbrooke, Quebec
Co-Applicant: Michelle Hladunewich

Detection of acute glomerular injury in the hypertensive disorders of pregnancy


2017-2019:  $100,000  |  Biomedical Research Grant  |  Category: Hypertension

Biography

Dr. Anne-Marie Côté, MD, MHSc, FRCPC, is a nephrologist and obstetrics consultant at the CIUSSS of the Estrie-CHUS and an associate professor in the Faculty of Medicine and Health Sciences at the Université de Sherbrooke. A member of the Centre de recherche du CHUS as a clinician scientist and the recipient of a FRQS-SQHA Jacques-de-Champlain Award, her research interests focus on renal impairment and the diagnosis of hypertensive disorders during pregnancy. Her research program is supported by, among others, the CIHR and The Kidney Foundation of Canada. She collaborated on updating the SOGC’s 2008 and 2014 clinical practice guidelines for hypertensive disorders of pregnancy, has been a member of the hypertension and pregnancy committee of Hypertension Canada since 2016, and sits on the boards of the Société Québécois d’Hypertension Artérielle, the North American Society for the Study of Hypertension in Pregnancy, and the Groupe d’Étude en Médecine Obstétricale du Québec.

Lay Summary

Preeclampsia is a very serious condition of pregnancy. It can be life threatening for both mother and baby. For the mother, one important sign includes high blood pressure, a condition called hypertension. Women who already have hypertension before pregnancy or during the first half of pregnancy are at even higher risk of preeclampsia.

Higher amounts of protein are also found in the urine of women with preeclampsia. This is known as proteinuria. Preeclampsia can damage the mother’s kidneys making them leak more protein than usual into her urine. It can also lead to other organ damage in the mother. Complications for babies can also be severe, including preterm birth and very low birth-weight. The accurate measurement of proteinuria is therefore crucial to the care of hypertensive women evaluated for preeclampsia. Important decisions such as hospitalization, drug prescription, and time of delivery all take into consideration proteinuria laboratory results amongst other signs and symptoms.

It is known that methods that are currently used to detect kidney damage during pregnancy need to be improved. One method is to measure albumin, one of the many proteins contained in urine. This is called albuminuria. Albuminuria has been shown to be better than proteinuria in persons with kidney disease or at risk outside of pregnancy (for example, when searching for kidney damage in diabetic patients). We think that albuminuria is also better for pregnant women.

Because special kidney cells called podocytes were recently found in the urine of women with preeclampsia, we will also assess if measuring specific podocyte proteins will help to further detect kidney damage in addition to albuminuria. We will also measure proteins in the blood that are linked to small vessel damage in women with preeclampsia.

Our goal is very straightforward: to improve the detection of kidney damage in women with high blood pressure during pregnancy by providing simple and accurate laboratory methods. This is crucial to the timely detection of preeclampsia and will help prevent its complications for mothers and their babies. Our project will also ensure Canadian leadership in this field.