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Renal disease in pregnancy

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https://www.readbyqxmd.com/read/28620300/novel-anti-fibrotic-therapies
#1
REVIEW
Benita L McVicker, Robert G Bennett
Fibrosis is a major player in cardiovascular disease, both as a contributor to the development of disease, as well as a post-injury response that drives progression. Despite the identification of many mechanisms responsible for cardiovascular fibrosis, to date no treatments have emerged that have effectively reduced the excess deposition of extracellular matrix associated with fibrotic conditions. Novel treatments have recently been identified that hold promise as potential therapeutic agents for cardiovascular diseases associated with fibrosis, as well as other fibrotic conditions...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28611078/midterm-egfr-and-adverse-pregnancy-outcomes-the-clinical-significance-of-gestational-hyperfiltration
#2
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...
June 13, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28598867/pathophysiology-of-antenatal-bartter-s-syndrome
#3
Martin Kömhoff, Kamel Laghmani
PURPOSE OF REVIEW: Antenatal Bartter syndrome (aBS) is a heterogenous disease resulting from defective ion transport in the thick ascending limb of the loop of Henle. Novel insights into the pathophysiology, as well as the recent identification of a novel genetic cause of aBS, merit an update on this topic. RECENT FINDINGS: In aBS, severe salt losing is further aggravated by defective salt sensing in the macula densa, where a reduced tubular salt concentration is perceived and glomerular filtration is increased instead of decreased...
June 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28593883/congenital-anomalies-of-the-kidney-and-urinary-tract-cakut
#4
Nadica Ristoska-Bojkovska
Congenital anomalies of the kidneys and urinary tract (CAKUT) are found in 3-6 out of 1.000 of the newborns, or according to some statistics they are represented in 0.5% of all pregnancies. Congenital abnormalities of the kidneys and urinary tract present a family of diseases of various anatomic spectrum, including renal anomalies, and anomalies of the bladder and urethra. The study was retrospective-prospective which means that it included newly diagnosed patients suffering from CAKUT, as well as those patients with already diagnosed and well defined CAKUT on the basis of imaging studies which have been processed according to the protocol for this study...
March 1, 2017: Prilozi (Makedonska Akademija Na Naukite i Umetnostite. Oddelenie za Medicinski Nauki)
https://www.readbyqxmd.com/read/28587539/treatment-of-patients-with-aortic-disease-during-pregnancy-and-after-delivery
#5
Yu-Yong Liu, Hai-Yang Li, Wen-Jian Jiang, Xin-Liang Guan, Xiao-Long Wang, Ou Liu, Jun-Ming Zhu, Li-Zhong Sun, Hong-Jia Zhang
Objective This study aimed to review treatment of patients with aortic disease during pregnancy and after delivery in Beijing Anzhen Hospital. Methods A retrospective study was conducted using data from 12 patients with aortic disease during pregnancy and after delivery in our institution from May 2005 to December 2014. Patients were provided different treatments based on the type of aortic disease and clinical characteristics. Results The mean age was 29.83 ± 4.17 years, mean height was 171.7 ± 8...
January 1, 2017: Journal of International Medical Research
https://www.readbyqxmd.com/read/28574590/pregnancy-outcomes-after-liver-transplantation-in-finland
#6
Mirjami Mattila, Helena Kemppainen, Helena Isoniemi, Päivi Polo-Kantola
Pregnancy after liver transplantation (LT) is possible but associated with increased risk of obstetrical complications. We report here for the first time the pregnancy outcomes after LT in Finland MATERIAL AND METHODS: All of the 25 pregnancies ending in deliveries after LT in Finland in 1998-2015 were analyzed. The data were collected from the mothers' medical records. The main outcome measures included pregnancy complications and the mode of the delivery. Neonatal outcome measures were birth weight, 5 minute Apgar score and umbilical artery pH RESULTS: There were 26 infants born...
June 2, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28552751/-ultrasound-of-the-fetal-urinary-system-during-the-first-trimester-of-pregnancy
#7
N Hamdaoui, A Dabadie, E Lesieur, E Quarello, M Kheiri, G Hery, B Guidicelli, F Bretelle, G Gorincour
The detection of abnormalities of the fetal urinary system in the first trimester of pregnancy is constantly improving, namely owing to the improved resolution of the image, the use of the endovaginal approach and thanks to sonographers' constant training. The pathological aspects, usually detected in the second trimester of pregnancy, can be suspected early in the first trimester and range from kidneys' cavity dilation to bilateral renal agenesis, polycystic kidney disease, multi-cystic dysplasia and bladder megavessia or bladder exstrophy...
May 25, 2017: Gynecologie, Obstetrique, Fertilite & Senologie
https://www.readbyqxmd.com/read/28536761/-anticoagulation-direct-oral-anticoagulants
#8
B Kemkes-Matthes
Since direct oral anticoagulants (DOAC) have become available, use of anticoagulant treatment has become easier and safer-for patients suffering from thromboembolic diseases as well as for patients with atrial fibrillation: Because of constant bioavailability, fixed dose regimen treatment is possible, monitoring not necessary and severe bleeding complications-particularly intracranial hemorrhages-rare in comparison to vitamin K anticoagulants. To gain all these advantages, it is essential to give DOAC in the correct dosage...
May 23, 2017: Der Internist
https://www.readbyqxmd.com/read/28522651/pregnancy-and-glomerular-disease-a-systematic-review-of-the-literature-with-management-guidelines
#9
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/28497091/restless-leg-syndrome-in-chronic-hemodialysis-patients-in-mashhad-hemodialysis-centers
#10
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
#11
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/28460070/pregnancy-in-women-with-immunoglobulin-a-nephropathy-are-obstetrical-complications-associated-with-renal-prognosis
#12
Sehoon Park, Kyung Don Yoo, Joong Shin Park, Joon-Seok Hong, Seungdon Baek, Su-Kil Park, Ho Jun Chin, Ki Young Na, Yunhee Choi, Dong Ki Kim, Kook-Hwan Oh, Kwon Wook Joo, Yon Su Kim, Hajeong Lee
Background.: Recent studies regarding immunoglobulin A nephropathy (IgAN) suggest no relationship between pregnancy and disease progression, although complicated pregnancies and impaired renal function are closely related. Methods.: This study used a propensity-score-matched cohort analysis. Among biopsy-confirmed IgAN women in three hospitals in Korea, those who experienced pregnancy after their diagnosis were included in the study group. Renal outcome was the composite of serum creatinine doubling, estimated glomerular filtration rate (eGFR) halving and events of end-stage renal disease...
April 28, 2017: Nephrology, Dialysis, Transplantation
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
#13
Alice Faure, Nicoleta Panait, Michel Panuel, Pierre Alessandrini, Claude D'Ercole, Kathia Chaumoitre, Thierry Merrot
METHODS: Between 2003 and 2014, 11 MRI were performed on fetuses (between 28-32 weeks) in whom second trimester sonography suggested severe bilateral urinary tract anomalies, suspected of PUV. RESULTS: The ADC of the 11 fetuses ranged from 1.3 to 2.86 mm2 s - 1 (median = 1.79 mm2s - 1, normal range for fetal kidney: 1.1-1.8). Two pregnancies with ADC > 2.6 mm2s - 1 were interrupted; the autopsy confirmed PUV and Potter syndrome. For the remaining nine babies, the follow-up was 5...
April 28, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28438765/longitudinal-characterization-of-renal-proximal-tubular-markers-in-normotensive-and-preeclamptic-pregnancies
#14
Elisabeth Codsi, Vesna D Garovic, Maria L Gonzalez-Suarez, Natasa Milic, Kristi S Borowski, Carl H Rose, Norman P Davies, Kianoush Kashani, John C Lieske, Wendy M White
Glomerular damage is common in preeclampsia (PE), but the extent and etiology of tubular injury are not well understood. The aim of this study was to evaluate tubular injury in patients with PE and to assess whether it predates clinical disease. We performed a prospective cohort study of 315 pregnant women who provided urine samples at the end of the second trimester and at delivery. This analysis included women who developed PE (n=15), gestational hypertension (GH) (n=14), and normotensive controls (NC) (n=44)...
April 24, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28436367/bilateral-obstructing-ureteric-calculi-in-pregnancy-a-rare-cause-of-acute-renal-failure
#15
Todd G Manning, Daniel Christidis, David Wetherell, Ruth Cameron-Jeffs, Nathan Lawrentschuk
Bilateral obstructing ureteric calculi is a rare cause of acute renal failure. Although urolithiasis in later pregnancy is not uncommon, the development of bilateral obstruction secondary to ureteric calculi in the first trimester is rare and poses difficulty to diagnosis and management. Symptoms of diseases and physiological changes associated with pregnancy can obscure diagnosis of urolithiasis and obstructive uropathy. Advances in minimally invasive endourology afford intervention with reduced risk to fetal health...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28426127/postpartum-hypertension-etiology-diagnosis-and-management
#16
Kathryn J Sharma, Sarah J Kilpatrick
Importance: Postpartum hypertension complicates approximately 2% of pregnancies and, similar to antepartum severe hypertension, can have devastating consequences including maternal death. Objective: This review aims to increase the knowledge and skills of women's health care providers in understanding, diagnosing, and managing hypertension in the postpartum period. Results: Hypertension complicating pregnancy, including postpartum, is defined as systolic blood pressure 140 mm Hg or greater and/or diastolic blood pressure 90 mm Hg or greater on 2 or more occasions at least 4 hours apart...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28426126/actinomyces-in-pregnancy-a-review-of-the-literature
#17
Sarah M Estrada, Everett F Magann, Peter G Napolitano
Importance: Actinomyces is commonly found in many areas of the body where it derives a benefit without harming the host. When it does infect the host during pregnancy, is that infection a threat to the obstetric patient and does that infection cause adverse pregnancy outcomes? Objective: The aim of this study was to review what is known about Actinomyces infections and the impact of an Actinomyces infection on pregnancy outcomes. Evidence Acquisition: A PubMed search was undertaken with the search years unlimited to April 1, 2016, and restricted to articles in English...
April 2017: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/28416778/steroid-pulse-therapy-for-de-novo-minimal-change-disease-during-pregnancy
#18
Hiroshi Sato, Yuna Asami, Reona Shiro, Masato Aoki, Miki Yasuda, Saeko Imai, Rie Sakai, Kenji Oida, Kanako Kawaharamura, Hiroko Yano, Nao Taguchi, Takako Suzuki, Masaya Hirose
BACKGROUND Nephrotic syndrome occurs very rarely, in only about 0.01%-0.02% of all pregnancies, and de novo minimal change disease during pregnancy is especially rare. Nephrotic syndrome and, especially, minimal change disease are highly responsive to steroids, and preterm labor may be avoidable if the maternal condition is improved with steroid therapy. Therefore, prompt diagnosis and proper management are critical to maternal and fetal outcome when severe proteinuria occurs during pregnancy. CASE REPORT A 30-year-old pregnant Japanese woman presented with systemic edema, oliguria, and severe proteinuria and hypoalbuminemia at 25 weeks of gestation, although she was normotensive...
April 18, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28405942/first-successful-conception-induced-by-a-male-cystinosis-patient
#19
Koenraad R Veys, Kathleen W D'Hauwers, Angelique J C M van Dongen, Mirian C Janssen, Martine T P Besouw, Ellen Goossens, Lambert P van den Heuvel, Alex A M M Wetzels, Elena N Levtchenko
Cystinosis is a rare autosomal recessive lysosomal storage disease characterized by multi-organ cystine accumulation, leading to renal failure and extra-renal organ dysfunction. Azoospermia of unknown origin is the main cause of infertility in all male cystinosis patients. Although spermatogenesis has shown to be intact at the testicular level in some patients, no male cystinosis patient has been reported yet to have successfully induced conception.We present the first successful conception ever reported, induced by a 27-year-old male renal transplant infantile nephropathic cystinosis patient through percutaneous epididymal sperm aspiration (PESA) followed by intracytoplasmatic sperm injection (ICSI)...
April 13, 2017: JIMD Reports
https://www.readbyqxmd.com/read/28400421/kidney-outcomes-and-risk-factors-for-nephritis-flare-de-novo-in-a-multiethnic-cohort-of-pregnant-patients-with-lupus
#20
Jill P Buyon, Mimi Y Kim, Marta M Guerra, Sifan Lu, Emily Reeves, Michelle Petri, Carl A Laskin, Michael D Lockshin, Lisa R Sammaritano, D Ware Branch, T Flint Porter, Allen Sawitzke, Joan T Merrill, Mary D Stephenson, Elisabeth Cohn, Jane E Salmon
BACKGROUND AND OBJECTIVES: Kidney disease is a critical concern in counseling patients with lupus considering pregnancy. This study sought to assess the risk of renal flares during pregnancy in women with previous lupus nephritis in partial or complete remission, particularly in those with antidouble-stranded DNA antibodies and low complement levels, and the risk of new-onset nephritis in patients with stable/mildly active SLE. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We assessed active nephritis (renal flares and de novo kidney disease) and associated predictors during pregnancy in patients with lupus with urine protein ≤1000 mg and serum creatinine <1...
June 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
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