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Chronic renal disease and pregnancy

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https://www.readbyqxmd.com/read/28863222/chronic-kidney-disease-in-pregnancy
#1
REVIEW
Abhilash Koratala, Deepti Bhattacharya, Amir Kazory
With the increasing prevalence of chronic kidney disease (CKD) worldwide, the number of pregnant women with various degrees of renal dysfunction is expected to increase. There is a bidirectional relation between CKD and pregnancy in which renal dysfunction negatively affects pregnancy outcomes, and the pregnancy can have a deleterious impact on various aspects of kidney disease. It has been shown that even mild renal dysfunction can increase considerably the risk of adverse maternal and fetal outcomes. Moreover, data suggest that a history of recovery from acute kidney injury is associated with adverse pregnancy outcomes...
September 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28858635/comparison-of-risk-factors-and-perinatal-outcomes-in-early-onset-and-late-onset-preeclampsia-a-cohort-based-study-in-reunion-island
#2
Silvia Iacobelli, Francesco Bonsante, Pierre-Yves Robillard
Clinical differences, maternal risk factors and pregnancy outcomes of deliveries complicated by early- (delivery<34 weeks) and late-onset (delivery≥34 weeks) preeclampsia were studied in a cohort of women in Reunion Island during 15 years (period 2001-2015; N=62,230 pregnancies). The overall preeclampsia rate in singleton pregnancies was 2.37%. Early- and late-onset preeclampsia rates were 0.75% and 1.5% respectively, and the trend for each type of disease was stable over time. In both form of preeclampsia, smoking during pregnancy was a protective factor and associated risk factors were: older age, primiparity, pre-existing diabetes, chronic hypertension, higher pre-pregnancy body mass index and obesity, infertility treatment, history of renal disease and hypercholesterolemia (all p<0...
August 24, 2017: Journal of Reproductive Immunology
https://www.readbyqxmd.com/read/28753930/pregnancy-proteinuria-plant-based-supplemented-diets-and-focal-segmental-glomerulosclerosis-a-report-on-three-cases-and-critical-appraisal-of-the-literature
#3
Rossella Attini, Filomena Leone, Benedetta Montersino, Federica Fassio, Fosca Minelli, Loredana Colla, Maura Rossetti, Cristiana Rollino, Maria Grazia Alemanno, Antonella Barreca, Tullia Todros, Giorgina Barbara Piccoli
Chronic kidney disease (CKD) is increasingly recognized in pregnant patients. Three characteristics are associated with a risk of preterm delivery or small for gestational age babies; kidney function reduction, hypertension, and proteinuria. In pregnancy, the anti-proteinuric agents (ACE-angiotensin converting enzyme-inhibitors or ARBS -angiotensin receptor blockers) have to be discontinued for their potential teratogenicity, and there is no validated approach to control proteinuria. Furthermore, proteinuria usually increases as an effect of therapeutic changes and pregnancy-induced hyperfiltration...
July 19, 2017: Nutrients
https://www.readbyqxmd.com/read/28711072/chronic-kidney-disease-and-pregnancy
#4
Michelle A Hladunewich
Women with chronic kidney disease (CKD) are at risk for adverse pregnancy-associated outcomes, including progression of their underlying renal dysfunction, a flare of their kidney disease, and adverse pregnancy complications such as preeclampsia and preterm delivery. Earlier-stage CKD, as a rule, is a safer time to have a pregnancy, but even women with end-stage kidney disease have attempted pregnancy in recent years. As such, nephrologists need to be comfortable with pregnancy preparation and management at all stages of CKD...
July 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28708773/angiotensin-ii-responsiveness-after-preeclampsia-translational-data-from-an-experimental-rat-model-and-early-onset-human-preeclampsia
#5
Anne M van der Graaf, Tsjitske J Toering, Mienke W K van der Wiel, Anne-Roos S Frenay, Gerd Wallukat, Ralf Dechend, Gerjan Navis, Henk Groen, A Titia Lely, Marijke M Faas
OBJECTIVE: Formerly preeclamptic women have an increased risk for cardiovascular and renal disease later in life. It is unknown which mechanisms contribute to this increased risk and whether this is induced by preeclampsia or by prepregnancy factors. We hypothesized that the increased risk for cardiovascular disease is partly due to an increased angiotensin II (ang II) responsiveness postpartum and that preeclampsia itself is involved in inducing this increased ang II responsiveness. METHODS: In never-pregnant, formerly healthy pregnant rats and rats with former experimental preeclampsia [experimental preeclampsia model induced by low-dose endotoxin infusion on day 14 of pregnancy; endotoxin-infused pregnant rats (EP-rats)], ang II responsiveness was studied by measuring changes in blood pressure (BP) and proteinuria after chronic ang II infusion with osmotic minipumps (200 ng/kg per min)...
July 13, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28648010/-experience-of-sun-s-procedure-for-chronic-type-b-dissection-with-aortic-arch-involvement
#6
R D Qi, J M Zhu, L Chen, C N Li, Z Y Qiao, L J Cheng, Y P Ge, H O Hu, Y Xia, X Y Xing, T Zheng, Y M Liu, L Z Sun
Objective: To study the surgical treatment of chronic type B dissection with aortic arch involvement using Sun's procedure. Methods: Between February 2009 and December 2015, 29 patients [20 males, 9 females, with a mean age of (41±12) years, range 24-64 years] with type B dissection with aortic arch involvement underwent Sun's procedure. Sixteen patient had a history of hypertension. Marfan syndrome was observed in 9 cases, coronary artery disease in 3 cases, mitral regurgitation in 3 patients, cerebrovascular disease in one patient...
June 27, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28647487/does-pregnancy-have-any-impact-on-long-term-damage-accrual-and-on-the-outcome-of-lupus-nephritis
#7
Davide Gianfreda, Silvana Quaglini, Giulia Frontini, Francesca Raffiotta, Piergiorgio Messa, Gabriella Moroni
No data are available about the impact of pregnancy on the long-term outcome of lupus nephritis. Thirty-two women with lupus nephritis with a 10-year follow-up after their first pregnancy ("women who gave birth") and 64 matched controls with the same follow-up and who never had pregnancies ("controls") were compared for the occurrence of SLE flares, chronic kidney disease (CKD), and SLICC/ACR Damage Index (SDI) in the post pregnancy period. The same evaluations were done before and after pregnancy in women who gave birth...
June 21, 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28611078/midterm-egfr-and-adverse-pregnancy-outcomes-the-clinical-significance-of-gestational-hyperfiltration
#8
Sehoon Park, Seung Mi Lee, Joong Shin Park, Joon-Seok Hong, Ho Jun Chin, Ki Young Na, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
BACKGROUND AND OBJECTIVES: Although hemodynamic adaptation plays a crucial role in maintaining gestation, the clinical significance of midterm renal hyperfiltration (MRH) on pregnancy outcomes is unknown. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This was an observational cohort study. Women with a singleton pregnancy and a serum creatinine measurement during their second trimester were followed at two university hospitals in Korea between 2001 and 2015. Those with substantial renal function impairment or who delivered during the second trimester were not considered...
July 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#9
Niloufar Zadeh Saraji, Maryam Hami, Reza Boostani, Mohammad Javad Mojahedi
Introduction: Restless leg syndrome (RLS) is a sensory motor disorder. Patients with this syndrome have serious and uncontrollable desire to move their legs, which is mostly due to an uncomfortable feeling intensified when they are motionless. It may be a genetic disorder or secondary to iron deficiency, neurodegenerations, pregnancy, some drugs and severe kidney diseases. Objectives: This study was designed to find out the prevalence and its risk factors of RLS in hemodialysis patients. Patients and Methods: This multicenter cross-sectional study was done on 260 hemodialysis patients...
2017: Journal of Renal Injury Prevention
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#10
Chunhong Huang, Shanying Chen
BACKGROUND: Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates. OBJECTIVE: The aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population. METHODS: In this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70...
May 1, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28453880/predicting-postnatal-renal-function-of-prenatally-detected-posterior-urethral-valves-using-fetal-diffusion-weighted-magnetic-resonance-imaging-with-apparent-diffusion-coefficient-determination
#11
Alice Faure, Nicoleta Panait, Michel Panuel, Pierre Alessandrini, Claude D'Ercole, Kathia Chaumoitre, Thierry Merrot
OBJECTIVE: The objective of this study was to evaluate the accuracy of fetal diffusion-weighted magnetic resonance imaging with apparent diffusion coefficient (ADC) determination to predict postnatal renal function (nadir creatinine at 1 year and eGFR) of men with posterior urethral valves (PUV). METHODS: Between 2003 and 2014, 11 MRI were performed on fetuses (between 28 and 32 weeks) in whom second trimester sonography suggested severe bilateral urinary tract anomalies, suspected of PUV...
July 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28396746/pregnancy-outcomes-in-women-on-hemodialysis-a-national-survey
#12
Mala Sachdeva, Valerie Barta, Jyotsana Thakkar, Vipulbhai Sakhiya, Ilene Miller
Background. Pregnancy occurs among 1-7% of women on chronic dialysis. Experience regarding pregnancy and dialysis originates from anecdotal reports, case series and surveys. This survey updates the US nephrologists' experience with pregnancy on hemodialysis (HD) over the past 5 years. We evaluated maternal and fetal outcomes, certain practice patterns such as dialysis regimens utilized and nephrologist knowledge and comfort level when caring for a pregnant patient on HD. Methods. An anonymous Internet-based 23-question survey was e-mailed to end-stage renal disease Networks of America program directors for forwarding to practicing nephrologists...
April 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28352008/spectrum-of-renal-injury-in-pregnancy-induced-hypertension-experience-from-a-single-center-in-india
#13
Mahesh Eswarappa, Madhyastha Rakesh, Puri Sonika, K Snigdha, M Midhun, K Kaushik, Gurudev Konana Chennabasappa, Bande Sujeeth
Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M...
March 2017: Saudi Journal of Kidney Diseases and Transplantation
https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#14
REVIEW
Caroline L Knight, Catherine Nelson-Piercy
Systemic lupus erythematosus (SLE) is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal-neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy...
2017: Open Access Rheumatology: Research and Reviews
https://www.readbyqxmd.com/read/28303335/treatment-selection-for-urolithiasis-percutaneous-nephrolithomy-ureteroscopy-shock-wave-lithotripsy-and-active-monitoring
#15
Mahesh Desai, Yinghao Sun, Noor Buchholz, Andrew Fuller, Tadashi Matsuda, Brian Matlaga, Nicole Miller, Damien Bolton, Mohammad Alomar, Arvind Ganpule
Urolithiasis is a significant worldwide source of morbidity, constituting a common urological disease that affects between 10 and 15% of the world population. Recent technological and surgical advances have replaced the need for open surgery with less invasive procedures. The factors which determine the indications for percutaneous nephrolithotomy include stone factors (stone size, stone composition, and stone location), patient factors (habitus and renal anomalies), and failure of other treatment modalities (ESWL and flexible ureteroscopy)...
March 16, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/28279626/maternal-foetal-outcomes-in-pregnant-women-with-glomerulonephritides-are-all-glomerulonephritides-alike-in-pregnancy
#16
Giorgina Barbara Piccoli, Rossella Attini, Gianfranca Cabiddu, Isabelle Kooij, Federica Fassio, Martina Gerbino, Stefania Maxia, Marilisa Biolcati, Elisabetta Versino, Tullia Todros
In spite of the interest for chronic renal diseases (CKD) in pregnancy data on specific diseases is fragmentary; while recent studies analysed the most common glomerulonephritides (GN), none was addressed at GN as a group. The aim of our study was to analyse the main pregnancy-related outcomes in GN patients in a large multicentre cohort. Patients with a diagnosis of GN were selected from the TOCOS cohort (TOCOS: TOrino Cagliari Observational Study): out of 714 singleton deliveries GN was the diagnosis in 126; lupus GN and IgA nephropathy accounted for 37 and 33 cases; 1418 low-risk singleton deliveries followed-up in the same Centers served as controls (non diabetic, non nephropathic, non obese women, without any other known chronic illness; pregnancies after ovodonation or in vitro fertilisation were excluded, if declared)...
May 2017: Journal of Autoimmunity
https://www.readbyqxmd.com/read/28260455/triplet-pregnancy-in-a-diabetic-mother-with-kidney-transplant-case-report-and-review-of-the-literature
#17
Tarek Mahmoud, Khalida Mujaibel, Hosam Attia, Zakaria Zakaria, Jude Yagan, Osama Gheith, Medhat Abdel Halim, Prasad Nair, Torki Al-Otaibi
Triplet and higher-order multiple pregnancies can carry increased fetal and maternal complications. Reports of triplet pregnancies after kidney transplant are scarce and have been associated with perinatal complications. Presence of diabetes in such cases worsens both fetal and maternal outcomes. Here, we present a triplet pregnancy in a kidney transplant recipient with diabetes. We also reviewed the literature for causes, prevalence, and outcomes in association with chronic kidney disease, kidney transplant, and diabetes mellitus...
February 2017: Experimental and Clinical Transplantation
https://www.readbyqxmd.com/read/28256177/complications-during-pregnancy-and-fetal-development-implications-for-the-occurrence-of-chronic-kidney-disease
#18
REVIEW
Ashley D Newsome, Gwendolyn K Davis, Norma B Ojeda, Barbara T Alexander
Numerous epidemiological studies indicate an inverse association between birth weight and the risk for chronic kidney disease. Areas covered: Historically, the first studies to address the developmental origins of chronic disease focused on the inverse relationship between birth weight and blood pressure. A reduction in nephron number was a consistent finding in low birth weight individuals and experimental models of developmental insult. Recent studies indicate that a congenital reduction in renal reserve in conjunction with an increase in blood pressure that has its origins in fetal life increases vulnerability to renal injury and disease...
March 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#19
REVIEW
Philip Webster, Liz Lightstone, Dianne B McKay, Michelle A Josephson
Chronic kidney disease (CKD) affects up to 6% of women of childbearing age in high income countries, and is estimated to affect 3% of pregnant women. Advanced renal dysfunction, proteinuria, hypertension, and poorly controlled underlying primary renal disease are all significant risks for adverse maternal, fetal, and renal outcomes. In order to achieve the best outcomes, it is therefore of paramount importance that these pregnancies are planned, where possible, to allow the opportunity to counsel women and their partners in advance and to optimize these risks...
May 2017: Kidney International
https://www.readbyqxmd.com/read/28161265/-reasons-for-first-consultation-in-nephrology-in-the-health-area-5-of-britanny-during-the-year-2014
#20
Jeanne Prévot, Sahar Bayat-Makoei, Cécile Vigneau
BACKGROUND: In France, the coordinated healthcare circuit means that patients should be referred to specialists, for example nephrologists, by another physician. However, there are no recommendations concerning the reasons justifying the referral to a nephrologist. The main purpose of our study is to describe the motif of first consultations in nephrology in the health area 5 of Brittany. METHODS: We retrospectively collected medical reports of first consultations by 17 nephrologists in the 4 centers of the study area, during the year 2014...
February 1, 2017: Néphrologie & Thérapeutique
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