Functional implications of renal adaptations in gestational hypertension

Summary

During pregnancy, major adaptations in renal morphology, hemodynamics, and transport occur to achieve the volume and electrolyte retention required in pregnancy. These complex changes can appear counterintuitive when considered in isolation. Additionally, in pregnancies complicated by a disorder, such as gestational hypertension, kidney function may be altered from normal pregnancy. To analyze how renal function is altered during pregnancy, we developed epithelial cell-based computational models of solute and water transport in a nephron of the kidney for a rat in midand late-pregnancy. The model represents known pregnancy-induced changes in renal transporters, including reduction in proximal tubule and medullary loop transporters. The pregnant rat nephron models predicted urine output and excretion consistent with measured values. Additionally, we simulated the inhibition and knockout of the ENaC and H+-K+-ATPase transporters.