| Pregnancy and chronic kidney disease: a challenge in all CKD stages. | |
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MedLine Citation:
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PMID: 20413442 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Giorgina Barbara Piccoli; Rossella Attini; Elena Vasario; Anne Conijn; Marilisa Biolcati; Federica D'Amico; Valentina Consiglio; Salvatore Bontempo; Tullia Todros |
Publication Detail:
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Type: Journal Article Date: 2010-04-22 |
Journal Detail:
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Title: Clinical journal of the American Society of Nephrology : CJASN Volume: 5 ISSN: 1555-905X ISO Abbreviation: Clin J Am Soc Nephrol Publication Date: 2010 May |
Date Detail:
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Created Date: 2010-05-10 Completed Date: 2010-08-12 Revised Date: 2011-07-28 |
Medline Journal Info:
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Nlm Unique ID: 101271570 Medline TA: Clin J Am Soc Nephrol Country: United States |
Other Details:
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Languages: eng Pagination: 844-55 Citation Subset: IM |
Affiliation:
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Struttura Semplice Nefrologia Department of Clinical and Biological Sciences, Azienda Sanitaria Ospedaliera Universitaria San Luigi Gonzaga, University of Torino, Torino, Italy. gbpiccoli@yahoo.it |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Biological Markers / blood Case-Control Studies Cesarean Section / statistics & numerical data Chronic Disease Creatinine / blood Female Glomerular Filtration Rate Humans Hypertension, Pregnancy-Induced / epidemiology Infant, Newborn Intensive Care, Neonatal / statistics & numerical data Italy / epidemiology Kidney / physiopathology Kidney Diseases / epidemiology*, physiopathology, therapy Logistic Models Maternal Health Services / statistics & numerical data Odds Ratio Pregnancy Pregnancy Complications / epidemiology*, physiopathology, therapy Pregnancy Outcome / epidemiology* Premature Birth / epidemiology Prospective Studies Proteinuria / epidemiology Risk Assessment Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Biological Markers; 60-27-5/Creatinine |
| Comments/Corrections | |
Comment In:
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Nat Rev Nephrol. 2010 Jul;6(7):385
[PMID:
20597159
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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