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https://www.readbyqxmd.com/read/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#1
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
#2
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
#3
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...
December 22, 2016: 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
#4
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
#5
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
#6
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/27939480/long-term-effects-of-gestational-hypertension-and-pre-eclampsia-on-kidney-function-record-linkage-study
#7
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
#8
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
#9
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
#10
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
#11
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/27604074/pregnancy-outcomes-after-kidney-graft-in-italy-are-the-changes-over-time-the-result-of-different-therapies-or-of-different-policies-a-nationwide-survey-1978-2013
#12
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 is the treatment of choice to restore fertility to women on renal replacement therapy. Over time, immunosuppressive, support therapies and approaches towards high-risk pregnancies have changed. The aim of this study was to analyse maternal-foetal outcomes in two cohorts of transplanted women who delivered a live-born baby in Italy in 1978-2013, dichotomized into delivery before and after January 2000. METHODS: A survey involving all the Italian transplant centres was carried out, gathering data on all pregnancies recorded since the start of activity at each centre; the estimated nationwide coverage was 75%...
November 2016: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/27541443/pregnancy-with-chronic-kidney-disease-maternal-and-fetal-outcome
#13
Juhi Bharti, Richa Vatsa, Seema Singhal, Kallol Kumar Roy, Sunesh Kumar, Vanamail Perumal, Jyoti Meena
OBJECTIVE: Pregnancy with chronic kidney disease (CKD) is considered to be high risk. The purpose of this study was to assess the effect of pregnancy on CKD and the fetomaternal outcome in these patients. STUDY DESIGN: A retrospective observational study was conducted in the Department of Obstetrics and Gynaecology, All India Institute of medical sciences, New Delhi over a period of 11 years. A total number of 80 pregnant patients with CKD were reviewed. Staging of CKD was done according to glomerular filtration rate (GFR)...
September 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27526407/reproductive-endocrinology-in-chronic-kidney-disease-patients-new-approaches-to-old-challenges
#14
Songul Onder, Sana Akbar, Rebecca J Schmidt
Sexual dysfunction is a common yet underreported problem among chronic kidney disease (CKD) patients. This article will review sexual dysfunction in both genders, pregnancy outcomes, and best practices for successful full-term pregnancy in patients with CKD, including those with dialysis dependence and kidney transplants.
November 2016: Seminars in Dialysis
https://www.readbyqxmd.com/read/27512298/changing-picture-of-acute-kidney-injury-in-pregnancy-study-of-259-cases-over-a-period-of-33-years
#15
J Prakash, P Pant, S Prakash, M Sivasankar, R Vohra, P K Doley, L K Pandey, U Singh
The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10...
July 2016: Indian Journal of Nephrology
https://www.readbyqxmd.com/read/27508620/-op-2b-03-glomerular-hyperfiltration-as-a-risk-factor-for-renal-impairment-and-hypertension-in-apparently-healthy-subjects
#16
A Vrdoljak, V Ivkovic, S Karanovic, Z Dika, V Domislovic, K Dapic, L Gallineo, E Ivandic, J Josipovic, I Vukovic, J Kos, M Laganovic, T Zeljkovic Vrkic, M Fistrek Prlic, I Pecin, M Fucek, J Sertic, N Leko, B Jelakovic
OBJECTIVE: Chronic kidney disease(CKD) is established CV risk factor, and already early renal impairment(RI) increases risk for hypertension(HT) and loss of renal function. It was reported that blood pressure (BP) and metabolic derangements are associated with glomerular hyperfiltration(GHF), and GHF increases risk of developing microalbuminuria (MA) in HT stage 1. Our aim was to analyze whether GHF predicts progression to HT and RI in apparently healthy subjects. DESIGN AND METHOD: Out of 954 subjects enrolled in ENAH follow-up study, 371 (137 m, 234 w; mean age = 46 years) 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/27491315/prevalence-of-chronic-kidney-disease-after-preeclampsia
#17
Veronica Agatha Lopes van Balen, Julia Jeltje Spaan, Tom Cornelis, Marc Erich August Spaanderman
BACKGROUND: Preeclampsia (PE), an endothelial disease that affects kidney function during pregnancy, is correlated to an increased future risk of cardiovascular and chronic kidney disease. The Kidney Disease Improving Global Outcomes (KDIGO) 2012 guideline emphasizes the combined role of glomerular filtration rate (GFR) and albuminuria in determining the frequency of monitoring of kidney function. OBJECTIVES: In this study we evaluated the prevalence of CKD in women with a history of PE...
August 5, 2016: Journal of Nephrology
https://www.readbyqxmd.com/read/27438974/urinary-abnormalities-and-renal-function-in-pregnant-women-with-chronic-hypertension
#18
Guilherme Santos da Silva Junior, Silvia Regina Moreira, Sonia K Nishida, Nelson Sass, Gianna Mastroianni Kirsztajn
INTRODUCTION: Renal involvement in pregnant women with chronic hypertension is not widely known. OBJECTIVES: 1- To describe the epidemiological profile of pregnant women with chronic hypertension; 2- To evaluate urinary abnormalities (by urinalysis), renal function (serum creatinine and cystatin C, and estimated glomerular filtration rate (eGFR); 3- To evaluate the pregnancy outcome in chronic hypertension. METHODS: 103 pregnant women with chronic hypertension (blood pressure over 140/90 mmHg, detected previously to pregnancy or until the 20th week) were submitted to clinical and laboratorial evaluation...
June 2016: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/27366662/the-successful-clinical-outcomes-of-pregnant-women-with-advanced-chronic-kidney-disease
#19
Ji-Yeun Chang, Hanbeol Jang, Byung Ha Chung, Young-Ah Youn, In-Kyung Sung, Yong-Soo Kim, Chul Woo Yang
BACKGROUND: Successful pregnancy outcomes in patients with advanced chronic kidney disease (CKD) are increasingly common in Western countries. However, in Korea, the available literature addressing this clinical issue is scarce. METHODS: We reviewed 5 successful parturitions [1 patient with Stage 5 CKD and 4 with maintenance hemodialysis (HD)] at Seoul St. Mary's Hospital over 3 years and investigated changes in dialysis prescription, anemia management, and the incidence of maternal and neonatal complications...
June 2016: Kidney Research and Clinical Practice
https://www.readbyqxmd.com/read/27350132/pregnancy-in-women-with-ckd-a-success-story
#20
Matthew Hall
In women with chronic kidney disease (CKD), pregnancy outcomes have improved over the last 50 years, particularly in the developed world. Maternal mortality is now extremely low, fetal survival has markedly increased (even in women with CKD stages 4-5), and it is now the exception for women with CKD to be advised against embarking on a pregnancy. However, pregnancies are rarely free from complications, and there are unanswered questions about the longer term effects on maternal and infant health. The developments have led to a more optimistic attitude to pregnancy in women with CKD not requiring renal replacement treatment...
October 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
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