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Renal disease in pregnancy

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https://www.readbyqxmd.com/read/28216926/urological-disorders-and-pregnancy-an-overall-experience
#1
Debasmita Mandal, Mriganka Mouli Saha, Dillip Kumar Pal
AIM: Pregnancy is an anatomical and physiological altered state and the presence of various urological problems not only aggravates the disease itself, but also results in unfavourable pregnancy outcome. Aim is to highlight obstetric outcome in pregnant women with urological problems. MATERIALS AND METHODS: Longitudinal prospective cohort study conducted in tertiary care hospital, IPGME and R, Kolkata from Jan 2011 to Dec 2012. All pregnant women with urological problems were included as subjects...
January 2017: Urology Annals
https://www.readbyqxmd.com/read/28209494/effect-of-early-onset-preeclampsia-on-cardiovascular-risk-in-the-fifth-decade-of-life
#2
Anouk Bokslag, Pim W Teunissen, Constantijn Franssen, Floortje van Kesteren, Otto Kamp, Wessel Ganzevoort, Walter J Paulus, Christianne J M de Groot
BACKGROUND: Women with hypertensive disorders in pregnancy, in particular early-onset preeclampsia, are at increased risk of developing cardiovascular disease later in life. These women have a more than two-fold increased risk to die from cardiovascular diseases. Most studies focused on identification of risk factors shortly after pregnancy. Less is known on the prevalence of risk factors or actual signs of cardiovascular disease 5 - 20 years later. The presence of hypertension or metabolic syndrome can be seen as an opportunity for preventive interventions to reduce the development of severe cardiovascular diseases like myocardial infarction and stroke...
February 13, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28209334/pregnancy-in-chronic-kidney-disease-and-kidney-transplantation
#3
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/28202440/exposure-to-placental-ischemia-impairs-postpartum-maternal-renal-and-cardiac-function-in-rats
#4
Nina D Paauw, Jaap A Joles, Frank T Spradley, Bhavisha Bakrania, Zsuzsanna K Zellenger, Arie Franx, Marianne C Verhaar, Joey P Granger, A Titia Lely
INTRODUCTION: Women with a history of preeclampsia (PE) have an increased risk to develop cardiovascular and renal diseases later in life, but the mechanisms underlying this effect are unknown. In rats, we assessed whether placental ischemia results in long-term effects on the maternal cardiovascular and renal systems using the Reduced Uterine Perfusion Pressure (RUPP) model for PE. METHODS: Sprague-Dawley rats received either a SHAM or RUPP operation at gestational day 14...
February 15, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28161265/-reasons-for-first-consultation-in-nephrology-in-the-health-area-5-of-britanny-during-the-year-2014
#5
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/28160250/thiopurines-and-methotrexate-use-in-ibd-patients-in-a-biologic-era
#6
REVIEW
Gerassimos J Mantzaris
Although we have been living in the era of biologic therapy for several decades, the use of immunomodulators (primarily thiopurines [azathioprine and mercaptopurine] and less so methotrexate) still remains an important component of the inflammatory bowel disease (IBD) pharmaceutical arsenal. Thiopurines as monotherapy exert corticosteroid-sparing effects and can maintain long-term remission in a considerable proportion of patients who have frequent relapses and are or have become mesalazine and/or corticosteroid intolerant or refractory...
February 3, 2017: Current Treatment Options in Gastroenterology
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
#7
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
#8
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/28106649/neutrophil-gelatinase-associated-lipocalin-biomarker-and-urinary-tract-infections-a-diagnostic-case-control-study-nuti-study
#9
Jameca Renee Price, Larissa Guran, Jeong Youn Lim, Christina J Megli, Amanda L Clark, Sharon Renee Edwards, Mary Anna Denman, W Thomas Gregory
OBJECTIVES: Acute uncomplicated urinary tract infection (UTI) in women is often treated based on symptoms alone. Urinary tract infection symptoms are highly sensitive but lack specificity and result in overuse of antibiotics. We sought to determine if urine neutrophil gelatinase-associated lipocalin (uNGAL) levels in urine can accurately discriminate between UTI and healthy women. METHODS: We recruited adult women aged 18 to 85 years presenting in the ambulatory setting from November 2014 to January 2016...
January 18, 2017: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/28101117/maternal-mortality-ratio-and-causes-of-death-in-iri-between-2009-and-2012
#10
Marzieh Vahiddastjerdy, Nasrin Changizi, Abas Habibollahi, Leila Janani, Zahra Farahani, Farah Babaee
Objective: The Maternal Mortality Ratio is an important health indicator. We presented the distribution and causes of maternal mortality in Islamic Republic of Iran. Materials and methods: After provision of an electronic Registry system for date entry, a descriptive-retrospective data collection had been performed for all maternal Deaths in March 2009- March 2012. All maternal deaths and their demographic characteristic were identified by using medical registries, death certificates, and relevant codes according to International Classification of Diseases (ICD-9) during pregnancy, labor, and 42 days after parturition...
September 2016: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/28089907/adenosine-and-preeclampsia
#11
REVIEW
Rocío Salsoso, Marcelo Farías, Jaime Gutiérrez, Fabián Pardo, Delia I Chiarello, Fernando Toledo, Andrea Leiva, Alfonso Mate, Carmen M Vázquez, Luis Sobrevia
Adenosine is an endogenous nucleoside with pleiotropic effects in different physiological processes including circulation, renal blood flow, immune function, or glucose homeostasis. Changes in adenosine membrane transporters, adenosine receptors, and corresponding intracellular signalling network associate with development of pathologies of pregnancy, including preeclampsia. Preeclampsia is a cause of maternal and perinatal morbidity and mortality affecting 3-5% of pregnancies. Since the proposed mechanisms of preeclampsia development include adenosine-dependent biological effects, adenosine membrane transporters and receptors, and the associated signalling mechanisms might play a role in the pathophysiology of preeclampsia...
January 12, 2017: Molecular Aspects of Medicine
https://www.readbyqxmd.com/read/28077740/the-jarisch-herxheimer-reaction-after-antibiotic-treatment-of-spirochetal-infections-a-review-of-recent-cases-and-our-understanding-of-pathogenesis
#12
REVIEW
Thomas Butler
Within 24 hours after antibiotic treatment of the spirochetal infections syphilis, Lyme disease, leptospirosis, and relapsing fever (RF), patients experience shaking chills, a rise in temperature, and intensification of skin rashes known as the Jarisch-Herxheimer reaction (JHR) with symptoms resolving a few hours later. Case reports indicate that the JHR can also include uterine contractions in pregnancy, worsening liver and renal function, acute respiratory distress syndrome, myocardial injury, hypotension, meningitis, alterations in consciousness, seizures, and strokes...
January 11, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28074992/-antineutrophil-cytoplasmic-antibody-anca-associated-renal-vasculitis-and-pregnancy-report-of-one-case
#13
Jorge Vega, Gonzalo P Méndez
ANCA mediated vasculitis mainly occur between the fourth and fifth decade of life; therefore, it is very uncommon to see pregnant patients with the disease. Vasculitis may affect significantly the course of pregnancy; in turn pregnancy can change the course of vasculitis. We report a 20 years old woman with ANCA-mediated renal vasculitis lasting 10 years who consulted with a pregnancy of 15 weeks. She was in remission and had amenorrhea attributed to ovarian toxicity due to cyclophosphamide. Pregnancy had an uneventful course with spontaneous delivery at the 37th week, giving birth to a healthy newborn...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28008002/pregnancy-outcomes-after-clinical-recovery-from-aki
#14
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/28007512/-the-complex-phenotype-of-arc-syndrome-a-new-case
#15
A Giraud, F Ramond, C Cremillieux, R Touraine, H Patural, J-L Stephan
ARC syndrome (arthrogryposis - renal dysfunction - cholestasis) is a rare lethal multisystemic autosomal recessive disease. A newborn of consanguineous parents of Algerian descent presented cholestatic jaundice, dehydration, and Fanconi syndrome at 10 days of life. The blood smear showed a very characteristic gray appearance of platelets. A homozygous mutation was evidenced in the VPS33B gene. This gene codes for a protein involved in trafficking of intracellular vesicles. The mutation (c.604-2A>G) present in the heterozygous state in the parents affects an invariant base of the splice acceptor site and to our knowledge has not been reported yet...
February 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
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
#16
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
#17
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/28002851/prenatal-ultrasonographic-diagnosis-of-cataract-in-utero-manifestations-of-cryptic-disease
#18
Eran Ashwal, Asaf Achiron, Yinon Gilboa, Michal Berkenstadt, Mordecai Rosner, Reuven Achiron
Purpose To report and review our experience with antenatal evaluation for fetuses diagnosed with congenital cataract. Materials and Methods We retrospectively identified pregnancies diagnosed with fetal cataract during antenatal ultrasound. Evaluation of fetal eyes included intraocular anatomy and biometry. Data on fetal malformations, serology and fetal karyotype were collected. Results 8 cases, identified over the course of 10 years, were reviewed. Week 15 was the mean time for diagnosis (range 11 - 34)...
December 21, 2016: Ultraschall in der Medizin
https://www.readbyqxmd.com/read/28001098/pre-eclampsia-and-risk-of-subsequent-hypertension-in-an-american-indian-population
#19
Lyle G Best, Laramie Lunday, Elisha Webster, Gilbert R Falcon, James R Beal
BACKGROUND AND OBJECTIVES: Pre-eclampsia (PE) shares a number of proposed pathophysiologic mechanisms related to those implicated in cardiovascular disease (CVD), such as endothelial dysfunction, inflammation, insulin resistance, and impaired renal regulation. PE has also been associated with subsequent hypertension, CVD, and related mortality in later life. METHODS: At follow-up, the four most recent blood pressures, body mass index (BMI), and use of hypertensive medications were recorded from clinic visits of 130 PE cases and 289 normal pregnancies...
December 21, 2016: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/27998874/-analysis-of-pregnancy-outcomes-in-66-patients-with-systemic-lupus-erythematosus
#20
Xiu-Zhen Song, Jia-Mian Chen, Qiu-Gen Zhou
OBJECTIVE: To analyze the outcomes of pregnancies in women with systemic lupus erythematosus (SLE) and the risk factors affecting the outcomes. METHODS: The data of SLE patients with pregnancy admitted from October, 2006 and September, 2015 were analyzed for assessing the maternal and fetal outcomes and complications. Their risk factors affecting the outcomes of the pregnancies were analyzed. RESULTS: The 66 SLE patients (69 pregnancies) had a mean age at SLE diagnosis of 22...
December 20, 2016: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
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