CKD stage 3b-5 and proteinuria in pregnancy may worsen renal and maternal outcomes
China: Chronic kidney disease (CKD) stage 3b-5 and proteinuria during early pregnancy predict adverse obstetric and renal outcomes, says a new study published in Pregnancy Hypertension.
The study found that pregnancy outcomes of patients with proteinuria less than 1 g/24 h and stage 3a CKD to be acceptable. And, pregnancy accelerates the deterioration of renal function more significantly in patients with stage 3-5 CKD and urinary protein concentrations above 1 g/24 h.
The study was conducted by Yingdong He, Department of Obstetrics and Gynecology, Peking University, First Hospital, Beijing, PR, China, and colleagues to examine pregnancy outcomes and the effects of pregnancy on kidney function in patients with stage 3-5 chronic kidney disease in a retrospective study.
For this purpose, the researchers analyzed clinical data of women with pregnancies complicated by stage 3-5 CKD who did their delivery in the Peking University First Hospital from January 1st, 2013, to December 31st, 2020. A total of difty-three patients with 54 pregnancies were studied.
The study led to the following findings:
- The mean levels of serum creatinine and eGFR in the first trimester were 138.4±76.7 umol/l and 44.9±13.5 ml/min/1.73m2, respectively. The perinatal mortality rate was 1.92%.
- The mean gestational age at birth was 35.4 weeks, and the average infant birth weight was 2333 g.
- The average gestational week at delivery of patients with stage 3a CKD was 36.8±2.1 weeks and there were no adverse neonatal outcomes.
- Compared with that in early pregnancy, the mean eGFR at 6 months after delivery decreased (52.3±7.3 vs 44.8±10.5 ml/min per 1.73m2) in patients with stage 3a CKD and urine protein≥1 g/24 h and in patients with stage 3b CKD and urine protein≥1 g/24 h (38.0±2.7 vs. 26.9±10.1 ml/min per 1.73m2).
The authors concluded their study by saying that, "CKD stage 3b-5 and proteinuria in early pregnancy are important predictors of adverse obstetric and renal outcomes."
Reference:
The study titled, "Pregnancy in patients with stage 3-5 CKD: maternal and fetal outcomes," appears in the journal Pregnancy Hypertension. DOI: https://doi.org/10.1016/j.preghy.2022.06.005
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