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pregnancy and CKD

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https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#1
Kimberly Blom, Ayodele Odutayo, Kate Bramham, Michelle A Hladunewich
During pregnancy, CKD increases both maternal and fetal risk. Adverse maternal outcomes include progression of underlying renal dysfunction, worsening of urine protein, and hypertension, whereas adverse fetal outcomes include fetal loss, intrauterine growth restriction, and preterm delivery. As such, pregnancy in young women with CKD is anxiety provoking for both the patient and the clinician providing care, and because the heterogeneous group of glomerular diseases often affects young women, this is an area of heightened concern...
May 18, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28513285/hypertensive-disorders-of-pregnancy-increase-the-risk-for-chronic-kidney-disease-a-population-based-retrospective-study
#2
Maika Oishi, Kaori Iino, Kanji Tanaka, Kana Ishihara, Yoshihito Yokoyama, Ippei Takahashi, Hideki Mizunuma
Hypertensive disorders of pregnancy (HDP) and chronic kidney disease (CKD) are well-known risk factors for cardiovascular disease (CVD) in later life. However, few studies have investigated the association of HDP with CKD. Moreover, these studies utilized either registry- or clinical-based data and did not include subclinical CKD patients. To address this gap in the literature, we investigated whether HDP is related to CKD, diagnosed based on the estimated glomerular filtration rate (eGFR), in later life. We designed a population-based, retrospective study, and reviewed the results of blood and physiological examinations as well as the results of pregnancy data available in patients' Maternity Health Record Books for 312 women...
May 17, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/28460634/acute-kidney-injury-during-pregnancy-and-puerperium-a-retrospective-study-in-a-single-center
#3
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/28434090/a-best-practice-position-statement-on-the-role-of-the-nephrologist-in-the-prevention-and-follow-up-of-preeclampsia-the-italian-study-group-on-kidney-and-pregnancy
#4
Giorgina Barbara Piccoli, Gianfranca Cabiddu, Santina Castellino, Giuseppe Gernone, Domenico Santoro, Gabriella Moroni, Donatella Spotti, Franca Giacchino, Rossella Attini, Monica Limardo, Stefania Maxia, Antioco Fois, Linda Gammaro, Tullia Todros
Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide...
April 22, 2017: Journal of Nephrology
https://www.readbyqxmd.com/read/28357675/what-is-the-role-of-nephrologists-and-nurses-of-the-dialysis-department-in-providing-fertility-care-to-ckd-patients-a-questionnaire-study-among-care-providers
#5
Gaby F van Ek, Esmée M Krouwel, Melianthe P J Nicolai, Brenda L Den Oudsten, Marjolein E M Den Ouden, Sandra W M Dieben, Hein Putter, Rob C M Pelger, Henk W Elzevier
PURPOSE: This study evaluated current fertility care for CKD patients by assessing the perspectives of nephrologists and nurses in the dialysis department. METHODS: Two different surveys were distributed for this cross-sectional study among Dutch nephrologists (N = 312) and dialysis nurses (N = 1211). RESULTS: Response rates were 50.9% (nephrologists) and 45.4% (nurses). Guidelines on fertility care were present in the departments of 9...
March 29, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28340831/pregnancy-and-delivery-in-the-sequel-of-kidney-transplantation-single-center-study-of-8-years-experience
#6
Y Yuksel, S Tekin, D Yuksel, I Duman, M Sarier, L Yucetin, E Turan, H Celep, T Ugurlu, M M Inal, Y H Asuman, A Demirbas
BACKGROUND: Depending on hyphothalamic, hyphophyseal, and gonadal axis dysfunction, anovulatory irregular cycles occur and the probability of pregnancy decreases in the patients with chronic kidney disease (CKD). Maternal mortality and morbidity rates are increased in CKD patients; the risk of premature delivery is 70% and the risk of preeclampsia is 40% more than normal among those with a creatine level of >2.5 mg/dL. METHODS: If a pregnancy is expected in the sequel of kidney transplantation (KT), a multidisciplinary team approach should be adopted and both the gynecologist and the nephrologist should follow the patient simultaneously...
April 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28327686/thyroid-hormone-profile-in-patients-with-chronic-kidney-disease-a-single-centre-study
#7
S Singh, A Verma, G Aryal, S Thapa, S Khakurel, K Shrestha
BACKGROUND: Chronic kidney disease (CKD) is a global burden and now recognized as a major public health problem worldwide. Patients with CKD have alteration in thyroid hormone metabolism. This study aims to evaluate the status of thyroid hormone profile in different stages of CKD. METHODS: The cross-sectional study included 103 CKD patients attending Nephrology and Dialysis unit of KIST Medical College Teaching Hospital, Lalitpur, Nepal. Serum creatinine, free triiodothyronine (fT3), free thyroxine (fT4), and thyroid stimulating hormone (TSH) were measured...
September 2016: Journal of Nepal Health Research Council
https://www.readbyqxmd.com/read/28320554/pregnancy-and-kidney-outcomes-in-patients-with-iga-nephropathy-a-cohort-study
#8
Xiaole Su, Jicheng Lv, Youxia Liu, Jinwei Wang, Xinxin Ma, Sufang Shi, Lijun Liu, Hong Zhang
BACKGROUND: The outcomes of pregnancy in immunoglobulin A nephropathy (IgAN) are controversial. This cohort study assessed the effects of pregnancy on kidney disease progression and risk factors for adverse pregnancy outcomes in patients with IgAN. STUDY DESIGN: A cohort study. SETTING & PARTICIPANTS: Women of child-bearing age with IgAN and minimum follow-up of 1 year after biopsy from December 2003 to September 2014. PREDICTORS: Pregnancy, treated as a time-dependent variable; baseline (at time of biopsy) estimated glomerular filtration rate (eGFR), proteinuria, blood pressure, and kidney pathology (Oxford MEST classification)...
March 17, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28279626/maternal-foetal-outcomes-in-pregnant-women-with-glomerulonephritides-are-all-glomerulonephritides-alike-in-pregnancy
#9
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/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#10
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/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
#11
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/28008002/pregnancy-outcomes-after-clinical-recovery-from-aki
#12
Jessica Sheehan Tangren, Camille E Powe, Elizabeth Ankers, Jeffrey Ecker, Kate Bramham, Michelle A Hladunewich, S Ananth Karumanchi, Ravi Thadhani
The effect of clinically recovered AKI (r-AKI) on future pregnancy outcomes is unknown. We retrospectively studied all women who delivered infants between 1998 and 2007 at Massachusetts General Hospital to assess whether a previous episode of r-AKI associated with subsequent adverse maternal and fetal outcomes, including preeclampsia. AKI was defined as rise in serum creatinine concentration to 1.5-fold above baseline. We compared pregnancy outcomes in women with r-AKI without history of CKD (eGFR>90 ml/min per 1...
May 2017: Journal of the American Society of Nephrology: JASN
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
#13
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
#14
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
#15
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)...
April 2017: Pediatric Research
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/27753900/os-01-09-markers-of-early-renal-impairment-in-prehypertension
#17
Ana Vrdoljak, Vanja Ivković, Sandra Karanović, Živka Dika, Ivana Vuković, Jelena Kos, Mario Laganović, Tajana Željković Vrkić, Margareta Fištrek Prlić, Ivan Pećin, Bojan Jelaković
OBJECTIVE: It was observed that glomerular hyperfiltration (GHF) is associated with progression of kidney disease in diabetics, patients in stage 1 hypertension (HT), and we found previously that eGFR decreased faster also in prehypertensives (PHT) with GHF. Here we analyzed whether GHF in PHT is associated with other biomarkers of early renal impairment. DESIGN AND METHOD: From 954 subjects enrolled in ENAH follow-up study, 371(137 m;mean age = 46years) were eligible for further analysis:100 with optimal,72 with normal BP,70 with PHT(high normal BP),and 129 with newly diagnosed untreated HT...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27689416/attitudes-in-patients-with-autosomal-dominant-polycystic-kidney-disease-toward-prenatal-diagnosis-and-preimplantation-genetic-diagnosis
#18
Oscar Swift, Enric Vilar, Belinda Rahman, Lucy Side, Daniel P Gale
AIMS: No recommendations currently exist regarding implementation of both prenatal diagnosis and preimplantation genetic diagnosis (PGD) for autosomal dominant polycystic kidney disease (ADPKD). This study evaluated attitudes in ADPKD patients with either chronic kidney disease (CKD) stages I-IV or end-stage renal failure (ESRF) toward prenatal diagnosis and PGD. METHODS: Ninety-six ADPKD patients were recruited from an outpatient clinic, wards, and dialysis units...
December 2016: Genetic Testing and Molecular Biomarkers
https://www.readbyqxmd.com/read/27649693/vegan-vegetarian-low-protein-supplemented-diets-in-pregnant-ckd-patients-fifteen-years-of-experience
#19
Rossella Attini, Filomena Leone, Silvia Parisi, Federica Fassio, Irene Capizzi, Valentina Loi, Loredana Colla, Maura Rossetti, Martina Gerbino, Stefania Maxia, Maria Grazia Alemanno, Fosca Minelli, Ettore Piccoli, Elisabetta Versino, Marilisa Biolcati, Paolo Avagnina, Antonello Pani, Gianfranca Cabiddu, Tullia Todros, Giorgina B Piccoli
BACKGROUND: Pregnancy in women with advanced CKD becoming increasingly common. However, experience with low-protein diets in CKD patients in pregnancy is still limited. Aim of this study is to review the results obtained over the last 15 years with moderately restricted low-protein diets in pregnant CKD women (combining: CKD stages 3-5, proteinuria: nephrotic at any time, or > =1 g/24 at start or referral; nephrotic in previous pregnancy). CKD patients on unrestricted diets were employed for comparison...
September 20, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27643246/os-01-09-markers-of-early-renal-impairment-in-prehypertension
#20
Ana Vrdoljak, Vanja Ivković, Sandra Karanović, Živka Dika, Ivana Vuković, Jelena Kos, Mario Laganović, Tajana Željković Vrkić, Margareta Fištrek Prlić, Ivan Pećin, Bojan Jelaković
OBJECTIVE: It was observed that glomerular hyperfiltration (GHF) is associated with progression of kidney disease in diabetics, patients in stage 1 hypertension (HT), and we found previously that eGFR decreased faster also in prehypertensives (PHT) with GHF. Here we analyzed whether GHF in PHT is associated with other biomarkers of early renal impairment. DESIGN AND METHOD: From 954 subjects enrolled in ENAH follow-up study, 371(137 m;mean age = 46years) were eligible for further analysis:100 with optimal,72 with normal BP,70 with PHT(high normal BP),and 129 with newly diagnosed untreated HT...
September 2016: Journal of Hypertension
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