Pregnancy with chronic kidney disease: maternal and fetal outcome

Urinary IgM excretion: a reliable marker for adverse pregnancy outcomes in women with chronic kidney disease

“…In accordance with previous studies, we found a high frequency of PE in our cohort (39.5%), but similar to the frequency in previous studies ranging from 38.9 to 55% [32, 33]. Previous studies have reported a frequency of preterm birth ranging from 17.5 to 43% and of SGA infants ranging from 35 to 64% [9, 32, 33]. In the present study, we also found similar frequencies (32.3 and 36.5%, respectively).…”

“…Particularly noteworthy is the fact that, in our study, a total 130 (77.8%) patients were diagnosed to have CKD during pregnancy. This contrasts with data reported in other studies, which found frequencies ranging from 17.5 to 27.5% [5, 33]. This discrepancy may stem from underdiagnosis because of the variable and subtle clinical manifestations, at least in the early phases of CKD.…”

“…To rule out the effects of potential confounders, the estimated ORs were adjusted for established risk factors. On the other hand, we are aware of the presence of certain limitations, including relatively late referral and a diagnosis of CKD mainly during pregnancy, precluding the analysis of other relevant outcomes, such as miscarriages; however, the frequency of combined and specific APO is in line with previous studies [9, 32, 33]. Unfortunately, we did not collect data on utero-placental flows before the development of PE, which may be considered as a limitation of this study.…”

Review article: Investigations and the pregnant woman in the emergency department – part 1: Laboratory investigations

“…It is also important to anticipate a rise in Cr from second to third trimester especially in women with pre-conception renal dysfunction. 66,67 Urinary protein and albumin excretion rise during pregnancy especially from 20 weeks gestation. 65,68 The amount of proteinuria may increase significantly during pregnancy in women with pre-conception proteinuria, complicating the diagnosis of superimposed pre-eclampsia.…”

“…It is important to recognise that Cr levels, which would be in the normal interval outside of pregnancy, may represent renal dysfunction during pregnancy. It is also important to anticipate a rise in Cr from second to third trimester especially in women with pre‐conception renal dysfunction . Urinary protein and albumin excretion rise during pregnancy especially from 20 weeks gestation .…”