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Chronic renal disease and pregnancy

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https://www.readbyqxmd.com/read/29305253/chronic-hypertension-first-trimester-blood-pressure-control-and-likelihood-of-severe-hypertension-preeclampsia-and-small-for-gestational-age
#1
Diane Nzelu, Dan Dumitrascu-Biris, Kypros H Nicolaides, Nikos A Kametas
BACKGROUND: There is extensive evidence that pre-pregnancy chronic hypertension is associated with high risk of development of severe hypertension and preeclampsia and birth of small for gestational age neonates. However, previous studies have not reported whether anti-hypertensive use, blood pressure control or normalization of blood pressure during early pregnancy influence the rates of these pregnancy complications. OBJECTIVE: To stratify women with pre-pregnancy chronic hypertension according to the use of antihypertensive medications and level of blood pressure control at the first hospital visit during the first-trimester of pregnancy and examine the rates of severe hypertension, preeclampsia and birth of small for gestational age neonates according to such stratification...
January 2, 2018: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29302904/acute-kidney-injury-in-pregnancy-with-special-reference-to-pregnancy-specific-disorders-a-hospital-based-study-2014-2016
#2
Jai Prakash, Vivek C Ganiger, Suraj Prakash, Mohammad Iqbal, Deba Prasad Kar, Usha Singh, Ashish Verma
INTRODUCTION: There are numerous reports in the literature describing acute kidney injury in pregnancy (P-AKI) due to various obstetric complications. However, there is a dearth of studies on AKI related to pregnancy-specific disorders from India. We aimed to analyze clinical features and outcome of P-AKI related to pregnancy-specific disorders compared to total pregnancy, in India. METHOD: All pregnant women attending the department of Obstetrics and Gynecology from November 2014 to July 2016 were screened for AKI based on: (1) sudden elevation of serum creatinine ≥ 1 mg/dl; (2) oligoanuria for > 12 h; and (3) need for dialysis...
January 4, 2018: Journal of Nephrology
https://www.readbyqxmd.com/read/29289477/kidney-function-after-a-hypertensive-disorder-of%C3%A2-pregnancy-a-longitudinal-study
#3
Nina D Paauw, Anne Marijn van der Graaf, Rita Bozoglan, David P van der Ham, Gerjan Navis, Ron T Gansevoort, Henk Groen, A Titia Lely
BACKGROUND: Registry-based studies report an increased risk for end-stage kidney disease after hypertensive disorders of pregnancy (HDPs). It is unclear whether HDPs lead to an increased incidence of chronic kidney disease (CKD) and/or progression of kidney function decline. STUDY DESIGN: Subanalysis of the Prevention of Renal and Vascular Endstage Disease (PREVEND) Study, a Dutch population-based cohort with follow-up of 5 visits approximately 3 years apart. SETTING & PARTICIPANTS: Women without and with patient-reported HDPs (non-HDP, n=1,805; HDP, n=977) were identified...
December 28, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/29233504/the-utility-of-anti-m%C3%A3-llerian-hormone-in-women-with-chronic-kidney-disease-on-haemodialysis-and-after-kidney-transplantation
#4
Sokratis Stoumpos, Jennifer Lees, Paul Welsh, Martin Hund, Colin C Geddes, Scott M Nelson, Patrick B Mark
Women with renal disease have menstrual and gonadal dysfunction manifesting as hormonal imbalance. Anti-Müllerian hormone (AMH) is a potential measure of ovarian reserve. We examined circulating AMH concentrations in young women with renal failure, determined associations with clinical characteristics, and compared AMH with age-matched healthy individuals. AMH was measured in 77 women: 26 had chronic kidney disease (CKD), 26 were on haemodialysis (HD), and 25 had a kidney transplant. Random AMH levels were highest in women on HD [HD 2...
November 28, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/29207220/-long-term-outcome-of-renal-function-in-women-with-preeclampia-and-pregestational-diabetes
#5
REVIEW
Carmela Vadalà, Valeria Cernaro, Rossella Siligato, Roberta Granese, Antonio Simone Laganà, Michele Buemi, Domenico Santoro
Pre-eclampsia (PE) is an important cause of acute renal failure and an important risk marker for subsequent chronic kidney disease. In normal pregnancy, there are marked changes in the renin-angiotensin system (RAS) including considerably elevated angiotensin II (ang II) levels. However, vascular resistance decreases markedly during normal pregnancy, suggesting that pregnant individuals are less sensitive to ang II than non-pregnant individuals. In contrast, during PE decreased circulating components of the RAS with enhanced sensitivity of ang II infusion have been reported...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29198741/pregnancy-as-an-early-stress-test-for-cardiovascular-and-kidney-disease-diagnosis
#6
Thaís Alquezar Facca, Gianna Mastroianni-Kirsztajn, Amélia Rodrigues Pereira Sabino, Michelle Tiveron Passos, Larissa Fátima Dos Santos, Eduardo Augusto Brosco Famá, Sonia Kiyomi Nishida, Nelson Sass
OBJECTIVES: Pregnancy is a cardiometabolic and renal stress test for women, primarily when associated with hypertension syndrome, which can have deleterious effects in the long term. We undertook this study to make a long-term evaluation on these women. STUDY DESIGN: A retrospective cohort study was conducted to investigate voluntary women who had pregnancy-induced hypertension syndrome versus normal pregnancy. MAIN OUTCOME MEASURES: We evaluated a total of 85 women, divided in case (n = 25) and control (n = 60) groups, by clinical, anthropometric and epidemiological profiles, general, metabolic and renal tests, and risk stratification for cardiovascular disease (CVD) and chronic kidney disease (CKD)...
November 23, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29122892/subclinical-first-trimester-renal-abnormalities-are-associated-with-preeclampsia-in-normoalbuminuric-women-with-type-1-diabetes
#7
Clare B Kelly, Michelle B Hookham, Jeremy Y Yu, Alicia J Jenkins, Alison J Nankervis, Kristian F Hanssen, Satish K Garg, James A Scardo, Samar M Hammad, M Kathryn Menard, Christopher E Aston, Timothy J Lyons
OBJECTIVE: This study was conducted to determine the utility of tubular (urinary/plasma neutrophil gelatinase-associated lipocalin [NGAL] and urinary kidney injury molecule 1 [KIM-1]) and glomerular (estimated glomerular filtration rate [eGFR]) biomarkers in predicting preeclampsia (PE) in pregnant women with type 1 diabetes mellitus (T1DM) who were free of microalbuminuria and hypertension at the first trimester. RESEARCH DESIGN AND METHODS: This was a prospective study of T1DM pregnancy...
November 9, 2017: Diabetes Care
https://www.readbyqxmd.com/read/29100716/acute-renal-cortical-necrosis-in-pregnancy-clinical-course-and-changing-prognosis
#8
Soumaya Beji, Meriam Hajji, Lamia Rais, Rania Kheder, Hela Jebali, Wided Smaoui, Madiha Krid, F Ben Hamida, Lilia Ben Fatma, Mohammed Karim Zouaghi
Obstetric cortical renal necrosis is a serious complication that can lead to chronic renal failure and the need for chronic dialysis. The aim of renal cortical necrosis therapy is to restore hemodynamic stability, institute early dialytic therapy, and treat the underlying cause of the disease. Most cases of renal cortical necrosis do not recover a normal renal function despite intensive care. We describe the course of a patient who was diagnosed with acute renal cortical necrosis in pregnancy treated with hemodialysis for three years but then she recovered her renal function...
October 31, 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29082653/telbivudine-therapy-for-gravidas-with-chronic-hepatitis-b-infection-and-patients-at-risk-of-renal-impairment
#9
REVIEW
J Liu, T Chen, Y Zhao
Hepatitis B virus infection is currently the most important cause of chronic viral hepatitis worldwide and is one of the most frequent causes of end-stage liver disease. With the international implementation of the hepatitis B vaccine and combined prophylaxis for infants born to HBsAg(+) mothers, the prevalence of hepatitis B has decreased remarkably. However, intra-uterine transmission has become a critical bottleneck for eliminating hepatitis B infection. The efficacy of nucleos(t)ide analogs on inhibiting hepatitis B replication has been widely confirmed, and the quality of life and the survival of individuals with chronic hepatitis B (CHB) have improved to a great degree...
November 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29046312/relaxin-mediated-renal-vasodilation-in-the-rat-is-associated-with-falls-in-glomerular-blood-pressure
#10
Aihua Deng, Kirk P Conrad, Chris Baylis
Relaxin (RLX) is a pleiotropic peptide hormone with marked renal vasodilatory actions which are physiologically important during pregnancy. RLX also has potent antifibrotic actions and is being tested therapeutically in various fibrotic diseases including chronic kidney disease (CKD). Since renal vasodilation may expose the glomerulus to increased blood pressure (PGC), which exacerbates progression of CKD, we assessed the glomerular hemodynamic actions of RLX when administered acutely (75 min; 0.89 µg/100g body weight/hr, iv) and chronically (1...
October 18, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29022223/acute-kidney-injury-in-pregnancy-and-the-role-of-underlying-ckd-a-point-of-view-from-m%C3%A3-xico
#11
REVIEW
Margarita Ibarra-Hernández, Oralia Alejandra Orozco-Guillén, María Luz de la Alcantar-Vallín, Ruben Garrido-Roldan, María Patricia Jiménez-Alvarado, Kenia Benitez Castro, Francisco Villa-Villagrana, Mario Borbolla, Juan Manuel Gallardo-Gaona, Guillermo García-García, Norberto Reyes-Paredes, Giorgina Barbara Piccoli
The incidence of acute kidney injury in pregnancy (P-AKI) in developed countries is significantly lower than in developing ones, where it is estimated to range between 4 and 26%. Mortality in cases of P-AKI requiring dialysis is high, varying from 20 to 80%. In developing countries, clinical decisions are often based on the availability of services and not on needs. Prenatal surveillance in Mexico does not include serum creatinine, limiting the potential for early diagnosis of AKI and CKD and their differential diagnosis...
December 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28992221/the-diabetes-pandemic-suggests-unmet-needs-for-ckd-with-diabetes-in-addition-to-diabetic-nephropathy-implications-for-pre-clinical-research-and-drug-testing
#12
Lidia Anguiano Gómez, Yutian Lei, Satish Kumar Devarapu, Hans-Joachim Anders
Curing 'diabetic nephropathy' is considered an unmet medical need of high priority. We propose to question the concept of 'diabetic nephropathy' that implies diabetes as the predominant cause of kidney disease, which may not apply to the majority of type 2 diabetics approaching end-stage kidney disease. With the onset of diabetes, hyperglycaemia/sodium-glucose co-transporter-2-driven glomerular hyperfiltration promotes nephron hypertrophy, which, however, on its own, causes proteinuria not before a decade later, probably because podocyte hypertrophy can usually accommodate an increase in the filtration surface...
July 31, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28987552/is-infection-an-independent-risk-factor-for-venous-thromboembolism-a-population-based-case-control-study
#13
Kevin P Cohoon, Aneel A Ashrani, Daniel J Crusan, Tanya M Petterson, Kent R Bailey, John A Heit
BACKGROUND: The independent association of recent infection with venous thromboembolism is uncertain. The purpose of the study was to test both overall infection (site unspecified) and specific infection sites as potential risk factors for deep vein thrombosis and pulmonary embolism adjusting for other known venous thromboembolism factors. METHODS: Using Rochester Epidemiology Project (REP) resources, we identified all Olmsted County, MN residents with objectively-diagnosed incident deep vein thrombosis or pulmonary embolism over the 13-year period, 1988-2000 (cases; n=1303), and 1-2 residents without venous thromboembolism matched to each case on age, sex and incident venous thromboembolism date (controls; n=1494)...
October 4, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28956309/pregnancy-related-acute-kidney-injury-in-high-income-countries-still-a-critical-issue
#14
REVIEW
Fadi Fakhouri, Clément Deltombe
The rate of pregnancy-associated acute kidney injury (P-AKI) has dwindled in high income countries mainly following the legalization of abortion in the seventies and early eighties and the general improvement in obstetrical care. P-AKI has not however disappeared from high income countries and several reports indicate that its frequency has even increased during the last decade. The reasons for such evolution are probably an improved surveillance and reporting of P-AKI and a more aggressive approach to the treatment of pregnancy complications, with unintended renal side effects...
December 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28863222/chronic-kidney-disease-in-pregnancy
#15
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
#16
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...
September 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
#17
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
#18
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
#19
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
#20
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]
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