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Renal disease in pregnancy

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https://www.readbyqxmd.com/read/29764231/important-considerations-in-pregnant-patients-with-lupus-nephritis
#1
Gabriella Moroni, Claudio Ponticelli
In the last few decades, identification of predictors of pregnancy outcome and appropriate pregnancy planning have significantly reduced the maternal and fetal risks in pregnant women with lupus nephritis. Areas covered: Successful pregnancies have been reported even in women with chronic renal disease and renal insufficiency. However, refractory hypertension and severe renal or cardiac chronic dysfunction are still considered contraindications to pregnancy. Pre-term delivery and fetal growth restriction may still occur in SLE patients more frequently than in healthy women, even in pregnancies regularly planned and monitored by a team of nephrologists and gynaecologists...
May 15, 2018: Expert Review of Clinical Immunology
https://www.readbyqxmd.com/read/29745907/diabetic-nephropathy-in-pregnant-women-with-type-1-diabetes-multiple-cases-review-and-discussion
#2
D Popovic, S Pejakovic, O Rankov, E Stokic, M Mitrovic
Pregnancy in women with pre-existing diabetes is associated with a doubled, or even up to four-fold increased risk of preeclampsia, preterm delivery, and perinatal mortality compared to the risk observed in a background population. Diabetic nephropathy (DN) is a progressive disease that affects about one third of diabetic patients and is among the most frequent causes of the end stage renal disease (ESRD) worldwide. In the random population, it is present in up to 7% of women with type 1 diabetes mellitus (T1DM), and it represents the most common chronic kidney disease occurring in graviditas, complicating between 2...
April 2018: Georgian Medical News
https://www.readbyqxmd.com/read/29745623/the-role-of-intraoperative-stroke-volume-variation-on-bleeding-during-functional-endoscopic-sinus-surgery
#3
Roberta Di Mauro, Fabiana Lucci, Federica Martino, Maria B Silvi, Eleonora Gidaro, Santo Di Lorenzo, Nicola Toschi, Stefano Di Girolamo, Mario Dauri
BACKGROUNDː Functional Endoscopic Sinus Surgery (FESS) is a minimally-invasive surgical technique for patients with paranasal sinus pathology. Surgical bleeding reduces operative field visibility and increases the incidence of serious complications. Epinephrine injection into the nasal mucosa and controlled hypotension are used to minimise bleeding. Hypotension carries risks and sometimes does not reduce surgical bleeding. The goal of this study is to discover which haemodynamic parameter better correlates with surgical bleeding...
May 9, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29744129/contributing-factors-of-pregnant-women-s-beliefs-towards-mode-of-delivery-a-cross-sectional-study-from-iran
#4
Fereshteh Zamani-Alavijeh, Marzieh Araban, Akbar Hassanzadeh, Khadije Makhouli
Background: Delivery is a critical event in every woman's life. Under some medical conditions, women sometimes undergo a cesarean section to save the life of themselves and their infant. Understanding the factors associated with choosing the type of delivery leads to more effective health interventions and the promotion of maternal and newborn health. The aim of this study is to determine contributing factors in pregnant women's beliefs toward the mode of delivery in a sample of women referring to Hojatieh Hospital in Isfahan, Iran...
2018: Maternal Health, Neonatology and Perinatology
https://www.readbyqxmd.com/read/29742659/anhydramnios-in-the-setting-of-renal-malformations-the-national-institutes-of-health-workshop-summary
#5
Marva Moxey-Mims, Tonse N K Raju
Anhydramnios in the setting of severe malformations of the fetal kidney and urinary tract is associated with a high incidence of stillbirths and life-threatening complications, including severe pulmonary hypoplasia, umbilical cord compression, and perinatal asphyxia. To prevent such adverse outcomes, some centers in the United States and elsewhere are offering amniotic fluid restoration for women diagnosed with anhydramnios in the setting of fetal renal malformations. The procedures include infusions of amniotic fluid substitutes (normal saline), percutaneously or through an amnioport-an implanted system for serial or continuous infusion of normal saline to maintain the desired amniotic fluid volume...
May 7, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29725630/glomerular-disease-in-women
#6
REVIEW
Kate Wiles, Liz Lightstone
Gender differences exist in the prevalence of glomerular diseases. Data based on histological diagnosis underestimate the prevalence of preeclampsia, which is almost certainly the commonest glomerular disease in the world, and uniquely gender-specific. Glomerular disease affects fertility via disease activity, the therapeutic use of cyclophosphamide, and underlying chronic kidney disease. Techniques to preserve fertility during chemotherapy and risk minimization of artificial reproductive techniques are considered...
March 2018: KI Reports
https://www.readbyqxmd.com/read/29719109/belatacept-during-pregnancy-in-renal-transplant-recipients-two-case-reports
#7
Jenna Combs, Anna Kagan, Mark Boelkins, Lisa Coscia, Michael Moritz, R Michael Hofmann
Impaired fertility is common among patients with chronic organ failure, including end stage renal disease (ESRD). Women of child-bearing age undergoing transplantation may experience rapid return of fertility. Pregnancy post-transplant presents numerous risks for the patient, fetus, and allograft. Maternal risks include hypertension and preeclampsia. Allograft risks include acute rejection and failure of the organ, and fetal risks include miscarriage, birth defects from immunosuppressants, premature delivery, and low birth weight...
May 2, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29700332/mitoq-supplementation-prevent-long-term-impact-of-maternal-smoking-on-renal-development-oxidative-stress-and-mitochondrial-density-in-male-mice-offspring
#8
Suporn Sukjamnong, Yik Lung Chan, Razia Zakarya, Long The Nguyen, Ayad G Anwer, Amgad A Zaky, Rachana Santiyanont, Brian G Oliver, Ewa Goldys, Carol A Pollock, Hui Chen, Sonia Saad
To investigate the effect of maternal MitoQ treatment on renal disorders caused by maternal cigarette smoke exposure (SE). We have demonstrated that maternal SE during pregnancy increases the risk of developing chronic kidney disease (CKD) in adult offspring. Mitochondrial oxidative damage contributes to the adverse effects of maternal smoking on renal disorders. MitoQ is a mitochondria-targeted antioxidant that has been shown to protect against oxidative damage-related pathologies in many diseases. Female Balb/c mice (8 weeks) were divided into Sham (exposed to air), SE (exposed to cigarette smoke) and SEMQ (exposed to cigarette smoke with MitoQ supplemented from mating) groups...
April 26, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29678837/infections-and-risk-of-peripartum-stroke-during-delivery-admissions
#9
Eliza C Miller, Marisa Gallo, Erin R Kulick, Alexander M Friedman, Mitchell S V Elkind, Amelia K Boehme
BACKGROUND AND PURPOSE: Peripartum strokes during delivery admissions are rare but have high maternal morbidity. Infections have been proposed as a possible stroke trigger. We hypothesized that women who had infections diagnosed at the time of delivery admission would have higher risk of stroke during their delivery hospitalization. METHODS: We conducted a case-control study using state inpatient administrative databases for California (2007-2011), Florida (2009-2011), and New York (2009-2011)...
April 20, 2018: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29677005/maged2-a-novel-form-of-antenatal-bartter-s-syndrome
#10
Martin Kömhoff, Kamel Laghmani
PURPOSE OF REVIEW: Antenatal Bartter's syndrome (aBS) is the most severe form of Bartter's syndrome, requiring close follow-up, in particular during the neonatal period, primarily because of prematurity. The recent identification of a novel and very severe form of aBS merits an update on this topic. RECENT FINDING: Despite the identification of several genes involved in Bartter's syndrome, about 20% of patients clinically diagnosed with aBS remained without genetic explanation for decades...
April 18, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29676801/prolonged-prenatal-hypoxia-selectively-disrupts-collecting-duct-patterning-and-postnatal-function-in-male-mouse-offspring
#11
Sarah L Walton, Reetu R Singh, Melissa H Little, Josephine Bowles, Joan Li, Karen M Moritz
KEY POINTS SUMMARY: In this study we investigated whether hypoxia during late pregnancy impairs kidney development in mouse offspring, and also whether this has long-lasting consequences affecting kidney function in adulthood. Hypoxia disrupted growth of the kidney, particularly the collecting duct network, in juvenile male offspring. By mid-late adulthood, these mice developed early signs of kidney disease, notably a compromised response to water deprivation. Female offspring showed no obvious signs of impaired kidney development and did not develop kidney disease, suggesting a underlying protection mechanism from the hypoxia insult...
April 20, 2018: Journal of Physiology
https://www.readbyqxmd.com/read/29674190/urinary-angiotensinogen-excretion-in-australian-indigenous-and-non-indigenous-pregnant-women
#12
Kirsty G Pringle, Celine Corbisier de Meaultsart, Shane D Sykes, Loretta J Weatherall, Lyniece Keogh, Don C Clausen, Gus A Dekker, Roger Smith, Claire T Roberts, Kym M Rae, Eugenie R Lumbers
The intrarenal renin-angiotensin system (iRAS) is implicated in the pathogenesis of hypertension, chronic kidney disease and diabetic nephropathy. Urinary angiotensinogen (uAGT) levels reflect the activity of the iRAS and are altered in women with preeclampsia. Since Indigenous Australians suffer high rates and early onset of renal disease, we hypothesised that Indigenous Australian pregnant women, like non-Indigenous women with pregnancy complications, would have altered uAGT levels. The excretion of RAS proteins was measured in non-Indigenous and Indigenous Australian women with uncomplicated or complicated pregnancies (preeclampsia, diabetes/gestational diabetes, proteinuria/albuminuria, hypertension, small/large for gestational age, preterm birth), and in non-pregnant non-Indigenous women...
April 11, 2018: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29669946/pravastatin-therapy-during-preeclampsia-prevents-long-term-adverse-health-effects-in-mice
#13
Nicola Garrett, Joaquim Pombo, Michelle Umpierrez, James E Clark, Mark Simmons, Guillermina Girardi
Preeclampsia (PE), associates with long-term increased risk for cardiovascular disease in women, suggesting that PE is not an isolated disease of pregnancy. It is not known if increased risk for long-term diseases is due to PE-specific factors or to prepregnancy renal and cardiovascular risk factors. We used a mouse model in which a WT female with normal prepregnancy health develops PE to investigate if preeclampsia causes long-term cardiovascular consequences after pregnancy for mothers and offspring. Mothers exhibited endothelial dysfunction and hypertension after PE and had glomerular injury that not only persisted but deteriorated, leading to fibrosis...
April 19, 2018: JCI Insight
https://www.readbyqxmd.com/read/29660063/five-successful-pregnancies-with-antenatal-anakinra-exposure
#14
Chelsey J F Smith, Christina D Chambers
Objectives: Our aim is to add to the limited existing prospective data on IL-1 inhibitor use in pregnancy. Methods: Data were obtained from the Organization of Teratology Information Specialists Autoimmune Disease in Pregnancy Project, a prospective cohort study of pregnancy outcomes in the USA and Canada. Eligible women were enrolled prior to 19 weeks' gestation between 2004 and 2017. Outcomes were obtained by maternal interview and medical record abstraction. Results: Five pregnancies with anakinra exposure were identified, all resulting in full-term singleton live births with no major or long-term complications...
April 12, 2018: Rheumatology
https://www.readbyqxmd.com/read/29658461/-monitoring-of-kidney-injury-in-preterm-infants
#15
Rong Zhang, Wen-Bin Dong
Acute kidney injury (AKI) is a common complication in the neonatal intensive care unit that causes a high mortality of preterm infants and various chronic kidney diseases in adulthood. Preterm infants have immature development of the kidneys at birth. The kidneys continue to develop within a specific time window after birth. However, due to various factors during pregnancy and after birth, preterm infants tend to develop AKI. At present, serum creatinine and urine volume are used for the assessment of kidney injury, and their early sensitivity and specificity have attracted increasing attention...
April 2018: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
https://www.readbyqxmd.com/read/29644715/comparison-of-biochemical-analysis-of-fetal-serum-and-fetal-urine-in-the-prediction-of-postnatal-renal-outcome-in-lower-urinary-tract-obstruction
#16
Emmanuel Spaggiari, Julien J Stirnemann, Sara Benedetti, Sophie Dreux, Laurent J Salomon, Thomas Blanc, Jonathan Rosenblatt, Romain Favre, Yves Ville, Françoise Muller
OBJECTIVES: To compare the prognostic value of fetal serum biochemistry and fetal urine biochemistry in predicting renal outcome in LUTO. METHODS: We retrospectively studied renal outcome following a prenatal diagnosis of LUTO in cases for which both fetal blood and fetal urine were sampled. We classified the renal outcome as either "favorable", when postnatal renal function was normal, or "adverse", in the case of postnatal chronic renal failure or when renal histological lesions were present at autopsy in the case of termination of pregnancy...
April 12, 2018: Prenatal Diagnosis
https://www.readbyqxmd.com/read/29603707/comparative-evaluation-of-periodontal-status-of-chronic-renal-failure-patients-and-systemically-healthy-individuals
#17
Radhika Gupta, Uttam Kumar, Siddharth Mallapragada, Pallavi Agarwal
AIM: Periodontitis, a chronic infectious disease, affects most of the population at one time or the other and its expression is a combination of hosts, microbial agents, and environmental factors. Extensive literature exists for the relationship between periodontal disease and diabetes mellitus, cardiovascular diseases, and adverse pregnancy outcomes. Only a few studies performed in a limited number of patients have reported peri-odontal health status in chronic renal failure patients...
March 1, 2018: Journal of Contemporary Dental Practice
https://www.readbyqxmd.com/read/29595273/-life-threatening-manifestations-of-lupus-and-antiphospholipid-syndrome-in-internal-medicine
#18
Pavel Horák, Martina Skácelová, Jiří Vymětal, Markéta Schubertová
The clinical picture of systemic lupus and antiphospholipid syndrome is remarkably varied and disease manifestations are commonly very heterogeneous. Relatively often both diseases are associated with severe, acute and life threatening manifestations, which places demands on the knowledge of differential diagnostics and experience of the physicians. This article deals with the serious and mostly acute impairment of cardiovascular, respiratory, renal, gastrointestinal, hematopoietic or nervous systems, briefly discusses the acute pregnancy complication and summarizes the basic therapeutic option...
2018: Vnitr̆ní Lékar̆ství
https://www.readbyqxmd.com/read/29579822/highly-hla-sensitized-kidney-transplant-patients-in-a-transplant-center
#19
P K Garcia, J Toro, C Borda, C Gonzalez, M P Rodriguez, K Contreras
INTRODUCTION: Approximately 10% to 30% of patients on renal transplant waiting lists are sensitized, which gives them more time on the waiting list. Transplantation in this setting has a greater risk of rejection and decreased graft survival. New strategies of donor allocation through virtual crossmatching and optimization of immunosuppressive therapies in induction and maintenance have allowed the allocation of organs for this population, which in other circumstances would not be chosen for a kidney transplant...
March 2018: Transplantation Proceedings
https://www.readbyqxmd.com/read/29560763/pre-and-peripartal-management-of-a-woman-with-mcardle-disease-a-case-report
#20
Tina Stopp, Michael Feichtinger, Wolfgang Eppel, Thomas M Stulnig, Peter Husslein, Christian Göbl
McArdle disease or glycogen storage disease (GSD) type V is a rare autosomal recessive inherited disorder in skeletal muscle metabolism leading to exercise intolerance, muscle cramps and in some cases to rhabdomyolysis and acute renal failure due to elevated serum myoglobin levels. Albeit the uterine smooth muscle is not affected, pregnancy and delivery can be physically strenuous and may require specific anesthesiologic care. However, data on pregnancy progress and outcome and on special implications linked to anesthesia in women with McArdle's disease is scarce, thus posing a challenge to pre- and peripartal management...
March 21, 2018: Gynecological Endocrinology
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