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Chronic renal disease and pregnancy

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https://www.readbyqxmd.com/read/28331377/management-of-systemic-lupus-erythematosus-during-pregnancy-challenges-and-solutions
#1
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
#2
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
#3
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)...
March 6, 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
#4
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
#5
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
#6
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...
February 13, 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
#7
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
https://www.readbyqxmd.com/read/28114169/outcomes-of-pregnancies-after-kidney-transplantation-lessons-learned-from-ckd-a-comparison-of-transplanted-nontransplanted-chronic-kidney-disease-patients-and-low-risk-pregnancies-a-multicenter-nationwide-analysis
#8
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Rossella Attini, Martina Gerbino, Paola Todeschini, Maria Luisa Perrino, Ana Maria Manzione, Gian Benedetto Piredda, Elisa Gnappi, Flavia Caputo, Giuseppe Montagnino, Vincenzo Bellizzi, Pierluigi Di Loreto, Francesca Martino, Domenico Montanaro, Michele Rossini, Santina Castellino, Marilisa Biolcati, Federica Fassio, Valentina Loi, Silvia Parisi, Elisabetta Versino, Antonello Pani, Tullia Todros
BACKGROUND: Kidney transplantation (KT) may restore fertility in CKD. The reasons why materno-foetal outcomes are still inferior to the overall population are only partially known. Comparison with the CKD population may offer some useful insights for management and counselling.Aim of this study was to analyse the outcomes of pregnancy after KT, compared with a large population of non-transplanted CKD patients and with low-risk control pregnancies, observed in Italy the new millennium...
January 21, 2017: Transplantation
https://www.readbyqxmd.com/read/28106904/planned-early-delivery-versus-expectant-management-for-hypertensive-disorders-from-34-weeks-gestation-to-term
#9
REVIEW
Catherine Cluver, Natalia Novikova, Corine M Koopmans, Helen M West
BACKGROUND: Hypertensive disorders in pregnancy are significant contributors to maternal and perinatal morbidity and mortality. These disorders include well-controlled chronic hypertension, gestational hypertension (pregnancy-induced hypertension) and mild pre-eclampsia. The definitive treatment for these disorders is planned early delivery and the alternative is to manage the pregnancy expectantly if severe uncontrolled hypertension is not present, with close maternal and fetal monitoring...
January 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28005708/an-early-life-course-association-of-pulse-pressure-with-adulthood-estimated-glomerular-filtration-rate-evidence-from-a-large-community-based-birth-cohort-study
#10
Sumon K Das, Harold D McIntyre, Abdullah Al Mamun
BACKGROUND: Little is known about pulse pressure (PP) during early life and its association with renal function at young adulthood. This study describes an early life course association of PP with adult renal function at 30 years from a large community-based birth cohort study in Australia. METHOD: Sample comprises 1169 young adults aged 30 years from the Mater-University of Queensland Study of Pregnancy, whose blood pressure was recorded in at least three follow-ups (5, 14, 21, and 30 years) and renal function was assessed at 30 years...
February 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28005240/complicated-pregnancies-in-inherited-distal-renal-tubular-acidosis-importance-of-acid-base-balance
#11
Harald Seeger, Peter Salfeld, Rüdiger Eisel, Carsten A Wagner, Nilufar Mohebbi
Inherited distal renal tubular acidosis (dRTA) is caused by impaired urinary acid excretion resulting in hyperchloremic metabolic acidosis. Although the glomerular filtration rate (GFR) is usually preserved, and hypertension and overt proteinuria are absent, it has to be considered that patients with dRTA also suffer from chronic kidney disease (CKD) with an increased risk for adverse pregnancy-related outcomes. Typical complications of dRTA include severe hypokalemia leading to cardiac arrhythmias and paralysis, nephrolithiasis and nephrocalcinosis...
December 22, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27997529/renal-dysfunction-in-early-adulthood-following-birth-asphyxia-in-male-spiny-mice-and-its-amelioration-by-maternal-creatine-supplementation-during-pregnancy
#12
Stacey J Ellery, Domenic A LaRosa, Luise A Cullen-McEwen, Russell D Brown, Rod J Snow, David W Walker, Michelle M Kett, Hayley Dickinson
BACKGROUND: Acute kidney injury affects ~70% of asphyxiated newborns, and increases their risk of developing chronic kidney disease later in life. Acute kidney injury is driven by renal oxygen deprivation during asphyxia, thus we hypothesized that creatine administered antenatally would protect the kidney from the long-term effects of birth asphyxia. METHODS: Pregnant spiny mice were fed standard chow or chow supplemented with 5% creatine from 20-d gestation (midgestation)...
February 1, 2017: Pediatric Research
https://www.readbyqxmd.com/read/27993418/comparison-of-intravenous-ketorolac-at-three-single-dose-regimens-for-treating-acute-pain-in-the-emergency-department-a-randomized-controlled-trial
#13
Sergey Motov, Matthew Yasavolian, Antonios Likourezos, Illya Pushkar, Rukhsana Hossain, Jefferson Drapkin, Victor Cohen, Nicholas Filk, Andrew Smith, Felix Huang, Bradley Rockoff, Peter Homel, Christian Fromm
STUDY OBJECTIVE: Nonsteroidal anti-inflammatory drugs are used extensively for the management of acute and chronic pain, with ketorolac tromethamine being one of the most frequently used parenteral analgesics in the emergency department (ED). The drugs may commonly be used at doses above their analgesic ceiling, offering no incremental analgesic advantage while potentially adding risk of harm. We evaluate the analgesic efficacy of 3 doses of intravenous ketorolac in ED patients with acute pain...
December 16, 2016: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/27958636/intrauterine-growth-restriction-in-pregnant-women-after-kidney-transplantation-as-a-marker-of-preeclampsia
#14
Anna Cyganek, Filip Andrzej Dabrowski, Bronislawa Pietrzak, Zoulikha Jabiry-Zieniewicz, Barbara Grzechocinska, Anna Madej, Miroslaw Wielgos
OBJECTIVES: Delayed motherhood is associated with an increasing number of comorbidities such as glomerulonephritis, systemic lupus erythematosus, and diabetic nephropathy. Women after renal transplant belong to the group of patients who require a highly individualized approach to treatment and diagnosis. The aim of the study was to validate the commonly used diagnostic criteria for preeclampsia which seem to be irrelevant in patients with chronic renal insufficiency. MATERIAL AND METHODS: The course of pregnancy and delivery were retrospectively analyzed in 48 renal transplant patients...
2016: Ginekologia Polska
https://www.readbyqxmd.com/read/27940459/a-multicenter-cohort-study-of-histologic-findings-and-long-term-outcomes-of-kidney-disease-in-women-who-have-been-pregnant
#15
Philip Webster, Louise M Webster, H Terence Cook, Catherine Horsfield, Paul T Seed, Raquel Vaz, Clara Santos, Isabelle Lydon, Michele Homsy, Liz Lightstone, Kate Bramham
BACKGROUND AND OBJECTIVES: For many women pregnancy is the first contact with health services, thus providing an opportunity to identify renal disease. This study compares causes and long-term renal outcomes of biopsy-proven renal disease identified during pregnancy or within 1 year postpartum, with nonpregnant women. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Native renal biopsies (1997-2012), in women of childbearing age (16 to <50 years), from 21 hospitals were studied...
March 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/27939480/long-term-effects-of-gestational-hypertension-and-pre-eclampsia-on-kidney-function-record-linkage-study
#16
D Ayansina, C Black, S J Hall, A Marks, C Millar, G J Prescott, K Wilde, S Bhattacharya
OBJECTIVE: To assess the long term effects of hypertensive disorders of pregnancy on renal function. DESIGN: Cohort study where exposure was gestational hypertension or preeclampsia in the first pregnancy. Normotensive women formed the comparison group. SETTING: Aberdeen, Scotland. PARTICIPANTS: All women with date of birth on or before 30th June 1969 and at least their first singleton delivery recorded in the Aberdeen Maternity and Neonatal Databank...
October 2016: Pregnancy Hypertension
https://www.readbyqxmd.com/read/27908330/sepsis-in-special-populations
#17
REVIEW
Matthew P Borloz, Khalief E Hamden
Sepsis is recognized by the presence of physiologic and laboratory changes that reflect the inflammatory response to infection on cellular and systemic levels. Comorbid conditions, such as cirrhosis, end-stage renal disease, and obesity, alter patients' susceptibility to infection and their response to it once present. Baseline changes in vital signs and chronic medications often mask clues to the severity of illness. The physiologic, hematologic, and biochemical adjustments that accompany pregnancy and the puerperium introduce similar challenges...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27802074/gestational-chronodisruption-impairs-circadian-physiology-in-rat-male-offspring-increasing-the-risk-of-chronic-disease
#18
Natalia Mendez, Diego Halabi, Carlos Spichiger, Esteban R Salazar, Karina Vergara, Pamela Alonso-Vasquez, Pamela Carmona, Jose M Sarmiento, Hans G Richter, Maria Seron-Ferre, Claudia Torres-Farfan
Chronic exposure to light at night, as in shift work, alters biological clocks (chronodisruption), negatively impacting pregnancy outcome in humans. Actually the interaction of maternal and fetal circadian systems could be a key factor determining a fitting health in adults. We propose that chronic photoperiod shift (CPS) during pregnancy alter maternal circadian rhythms and impair circadian physiology in the adult offspring, increasing health risks. Pregnant rats were exposed to normal photoperiod (12 h light, 12 h dark) or to CPS until 85% of gestation...
December 2016: Endocrinology
https://www.readbyqxmd.com/read/27798035/effect-of-simple-targeted-diet-in-pregnant-women-with-metabolic-risk-factors-on-maternal-and-fetal-outcomes-esteem-study-protocol-for-a-pragmatic-multicentre-randomised-trial
#19
Bassel H Al Wattar, Julie Dodds, Anna Placzek, Eleni Spyreli, Amanda Moore, Richard Hooper, Lee Beresford, Tessa J Roseboom, Maira Bes-Rastrollo, Graham Hitman, Khalid S Khan, Shakila Thangaratinam
INTRODUCTION: Women with metabolic risk factors are at higher risk of adverse pregnancy outcomes. Mediterranean-based dietary interventions have the potential to minimise these risks. We aim to evaluate the effectiveness of a simple, targeted intervention modelled on Mediterranean diet in preventing maternal and fetal complications in pregnant women with metabolic risk factors. METHODS AND ANALYSIS: Pregnant women with a singleton pregnancy <18 weeks gestation, and without pre-existing diabetes, chronic renal disease and autoimmune diseases will be recruited...
October 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27771603/atraumatic-diplaced-bilateral-femoral-neck-fracture-in-a-patient-with-hypophosphatemic-rickets-in-postpartum-period-a-missed-diagnosis
#20
Erdal Uzun, Ali Eray Günay, Turan Bilge Kızkapan, Mahmut Mutlu
INTRODUCTION: Simultaneous bilateral femoral neck fracture is an uncommon condition. There are very few cases reported in the literature and most of these cases have underlying bone pathologies such as renal osteodystrophy and osteomalacia. In some cases bilateral femoral neck fractures occur due to generalized seizures or high-energy trauma. PRESENTATION OF CASE: In this case report "atraumatic bilateral femoral neck fracture in a 26year old woman in postpartum period with hypophosphatemic rickets disease" is presented...
October 17, 2016: International Journal of Surgery Case Reports
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