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EnglishBACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is a challenge for pregnancy. Its recent classification underlines the importance of its early phases. This study's aim was to evaluate outcomes of pregnancy according to CKD stage versus low-risk pregnancies followed in the same center. \ DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The prospective analysis was conducted from January 2000 to May 2009 with the start of observation at referral and end of observation 1 month after delivery. Ninety-one singleton deliveries were studied; 267 "low-risk" singleton pregnancies served as controls. Because of the lack of hard end points (death, start of dialysis), surrogate end points were analyzed (cesarean section, prematurity, neonatal intensive care). \ RESULTS: CKD outcome was worse than physiologic pregnancies: preterm delivery (44% versus 5%); cesarean section (44% versus 25%); and need for neonatal intensive care (26% versus 1%). The differences were highly significant in stage 1 CKD (61 cases) versus controls (CKD stage 1: cesarean sections = 57%, preterm delivery = 33%, intensive care = 18%). In CKD, proteinuria and hypertension were correlated with outcomes [proteinuria dichotomized at 1 g/24 h at referral: need for intensive care, relative risk (RR) = 4.16 (1.05 to 16.46); hypertension: preterm delivery, RR = 7.24 (2.30 to 22.79); cesarean section, RR = 5.70 (1.69 to 19.24)]. Statistical significance across stages was reached for preterm delivery [RR = 3.32 (1.09 to 10.13)]. \ CONCLUSIONS: CKD is a challenge for pregnancy from early stages. Strict follow-up is needed for CKD patients, even when there is normal renal function.
Pregnancy and Chronic Kidney Disease: A Challenge in All CKD Stages / Piccoli GB; Attini R; Vasario E; Conijn A; Biolcati M; D'Amico F; Consiglio V; Bontempo S; Todros T. - In: CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY. - ISSN 1555-905X. - 5:5(2010), pp. 844-855.
| Titolo: | Pregnancy and Chronic Kidney Disease: A Challenge in All CKD Stages |
| Autori Riconosciuti: | |
| Autori: | Piccoli GB; Attini R; Vasario E; Conijn A; Biolcati M; D'Amico F; Consiglio V; Bontempo S; Todros T |
| Data di pubblicazione: | 2010 |
| Abstract: | BACKGROUND AND OBJECTIVES: Chronic kidney disease (CKD) is a challenge for pregnancy. Its recent classification underlines the importance of its early phases. This study's aim was to evaluate outcomes of pregnancy according to CKD stage versus low-risk pregnancies followed in the same center. \ DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: The prospective analysis was conducted from January 2000 to May 2009 with the start of observation at referral and end of observation 1 month after delivery. Ninety-one singleton deliveries were studied; 267 "low-risk" singleton pregnancies served as controls. Because of the lack of hard end points (death, start of dialysis), surrogate end points were analyzed (cesarean section, prematurity, neonatal intensive care). \ RESULTS: CKD outcome was worse than physiologic pregnancies: preterm delivery (44% versus 5%); cesarean section (44% versus 25%); and need for neonatal intensive care (26% versus 1%). The differences were highly significant in stage 1 CKD (61 cases) versus controls (CKD stage 1: cesarean sections = 57%, preterm delivery = 33%, intensive care = 18%). In CKD, proteinuria and hypertension were correlated with outcomes [proteinuria dichotomized at 1 g/24 h at referral: need for intensive care, relative risk (RR) = 4.16 (1.05 to 16.46); hypertension: preterm delivery, RR = 7.24 (2.30 to 22.79); cesarean section, RR = 5.70 (1.69 to 19.24)]. Statistical significance across stages was reached for preterm delivery [RR = 3.32 (1.09 to 10.13)]. \ CONCLUSIONS: CKD is a challenge for pregnancy from early stages. Strict follow-up is needed for CKD patients, even when there is normal renal function. |
| Volume: | 5 |
| Fascicolo: | 5 |
| Pagina iniziale: | 844 |
| Pagina finale: | 855 |
| Digital Object Identifier (DOI): | 10.2215/CJN.07911109 |
| Parole Chiave: | Pregnancy; kidney disease |
| Rivista: | CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY |
| Appare nelle tipologie: | 03A-Articolo su Rivista |
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