Document Detail


Pregnancy and progression of IgA nephropathy: results of an Italian multicenter study.
MedLine Citation:
PMID:  20599307     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Whether pregnancy impacts on the long-term outcome of immunoglobulin A (IgA) nephropathy is unknown. This study aims to compare the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function who did and did not become pregnant. STUDY DESIGN: Multicenter longitudinal cohort study. SETTING & PARTICIPANTS: Women of childbearing age with biopsy-proven IgA nephropathy, serum creatinine level<or=1.2 mg/dL at diagnosis, and minimum follow-up of 5 years after biopsy recruited from 35 nephrology centers participating in a national collaborative study group of pregnancy and kidney disease sponsored by the Italian Society of Nephrology. PREDICTORS: Pregnancy, treated as a time-dependent variable; baseline proteinuria; hypertension; and kidney biopsy histologic characteristics. OUTCOME & MEASURES: Rate of change in estimated creatinine clearance, change in proteinuria, and new-onset hypertension. RESULTS: 245 patients were enrolled. Of these, 223 women (136 and 87 in the pregnancy and nonpregnancy groups, respectively) had serum creatinine levels<or=1.2 mg/dL at diagnosis. Baseline data (including age, estimated creatinine clearance, prevalence of hypertension, and histologic grade of kidney damage) were similar between groups with the exception of proteinuria (protein excretion, 1.33 vs 0.95 g/d in the pregnancy vs nonpregnancy groups, respectively; P=0.03). Kidney function decreased 1.31 mL/min/y (95% CI, 0.99-1.63) during a median follow-up of 10 years (range, 5-31 years) and did not differ between groups. Baseline proteinuria predicted a faster decrease, but did not modify the effect of pregnancy. Pregnancy did not affect changes in proteinuria over time or risk of new-onset hypertension. LIMITATIONS: Unrecognized or unmeasured factors associated with the decision of becoming pregnant might have influenced results. CONCLUSIONS: Pregnancy does not seem to affect the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function.
Authors:
Monica Limardo; Enrico Imbasciati; Pietro Ravani; Maurizio Surian; Diletta Torres; Gina Gregorini; Riccardo Magistroni; Daniela Casellato; Linda Gammaro; Claudio Pozzi;
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study    
Journal Detail:
Title:  American journal of kidney diseases : the official journal of the National Kidney Foundation     Volume:  56     ISSN:  1523-6838     ISO Abbreviation:  Am. J. Kidney Dis.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-23     Completed Date:  2010-09-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8110075     Medline TA:  Am J Kidney Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  506-12     Citation Subset:  IM    
Copyright Information:
Copyright (c) 2010 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.
Affiliation:
Department of Nephrology, Dialysis and Transplantation, A. Manzoni Hospital, Lecco, Italy.
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MeSH Terms
Descriptor/Qualifier:
Adult
Disease Progression
Female
Glomerulonephritis, IGA* / physiopathology
Humans
Italy
Kidney / physiopathology
Longitudinal Studies
Pregnancy
Pregnancy Complications* / physiopathology
Prospective Studies
Investigator
Investigator/Affiliation:
Monica Limardo / ; Claudio Pozzi / ; Enrico Imbasciati / ; Maurizio Surian / ; Diletta Torres / ; Gina Gregorini / ; Riccardo Magistroni / ; Daniela Casellato / ; Linda Gammaro / ; Sara Beati / ; Giancarlo Ambroso / ; Milena Maggio / ; Antonio Del Giudice / ; Vincenzo De Cristofaro / ; Ester Gallo / ; Giuseppe Gernone / ; Alessandra Marega / ; Roberto Rustichelli / ; Gianfranca Cabiddu / ; Cristiana Rollino / ; Emilia Fanciulli / ; Sandro Feriozzi / ; Paola Pecchini / ; Daniela Bizzarri / ; Marco D'Amico / ; Emanuela Proietti / ; Luciana Baratelli / ; Giovanni Battista Reinero / ; Giacomo Garibotto / ; Marcella Rocchietti / ; Landino Allegri / ; Mauro Dugo / ; Lino Cirami / ; Ciro Esposito / ; Luisa Amico / ; Paola Mariani / ; Ambrogio Baroli / ; M Giannattasio / ; P Stratta / ; D Montanaro / ; L Gesualdo / ; G Daidone / ; D Manfellotto / ; S Castellino / ; Gregorini / ; Imbasciati /

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