Glomerular Disease in Women

Wiles, Kate; Lightstone, Liz

doi:10.1016/j.ekir.2018.01.010

Cited by 17 publications

(13 citation statements)

References 122 publications

(134 reference statements)

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“…The care of pregnant patients with GN requires coordination and planning with an obstetriciangynecologist (OB-GYN) and maternal fetal medicine, as detailed in Figure 17. 63,64 A review of women diagnosed with GN showed that many patients presented during pregnancy with complications, and this may be an opportunity for healthcare providers to act early in the disease process. 65 Contraception is also an important consideration.…”

Section: Research Recommendationsmentioning

confidence: 99%

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Rovin¹,

Adler²,

Barratt³

et al. 2021

Kidney International

1,107

883

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S28 Introduction S30 Summary of recommendation statements and practice points S88 Chapter 1: General principles for the management of glomerular disease S115 Chapter 2: Immunoglobulin A nephropathy (IgAN)/immunoglobulin A vasculitis (IgAV) S128 Chapter 3: Membranous nephropathy S140 Chapter 4: Nephrotic syndrome in children S153 Chapter 5: Minimal change disease (MCD) in adults S161 Chapter 6: Focal segmental glomerulosclerosis (FSGS) in adults S172 Chapter 7: Infection-related glomerulonephritis S187 Chapter 8: Immunoglobulin-and complement-mediated glomerular diseases with a membranoproliferative glomerulonephritis (MPGN) pattern of injury S193 Chapter 9: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis S207 Chapter 10: Lupus nephritis S231 Chapter 11: Anti-glomerular basement membrane (Anti-GBM) antibody glomerulonephritis S235 Methods for guideline development S243 Biographic and disclosure information S254 Acknowledgments S256 ReferencesThis guideline is published as a supplement supported by KDIGO. The development and publication of this guideline are strictly funded by KDIGO, and neither KDIGO nor its guideline Work Group members sought or received monies or fees from corporate or commercial entities in connection with this work. The opinions or views expressed in this professional education supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources. Because of the differences between in vitro and in vivo systems and between laboratory animal models and clinical data in humans, in vitro and animal data may not necessarily correlate with clinical results.

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Section: Research Recommendationsmentioning

confidence: 99%

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Rovin¹,

Adler²,

Barratt³

et al. 2021

Kidney International

1,107

883

View full text Add to dashboard Cite

show abstract

“…Fertility is diminished in dialysis patients with a pregnancy incidence between < 1-7% [5,[25][26][27][28][29]. Menopause occurs in these women 4.5 years earlier than in healthy women and primary ovarian failure, defined as a sign of menopause before the age of 40 years, is frequent with a proportion of 14% in comparison to 0.01% in the general population [30][31][32].…”

Section: Discussionmentioning

confidence: 99%

Exclusion of pregnancy in dialysis patients: diagnostic performance of human chorionic gonadotropin

Haninger-Vacariu

Herkner

Matthias³

et al. 2020

BMC Nephrol

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Background: A positive pregnancy test in acute or chronically ill patients has implications for the use of potentially mutagenic or teratogenic products in urgent medical therapies such as the use of chemotherapies or therapies with immunosuppressants, for anesthesia, and for time-sensitive indications like urgent surgery or organ Transplantation. Despite a lack of evidence, it is currently believed that human chorionic gonadotropin serum concentrations are always elevated in female dialysis patients even without pregnancy. It is also believed that human chorionic gonadotropin cannot be used to confirm or exclude pregnancy. Methods: Human chorionic gonadotropin was examined in female dialysis patients (18-50 years of age), and was classified as positive above 5 mlU/ml. In addition, fertility status was determined. For an enhanced index test, the cutoff of 5 mIU/ml was used for potentially fertile patients and 14 mIU/ml for infertile patients to calculate diagnostic test accuracy. The ideal cutoff for human chorionic gonadotropin was estimated using Liu's method with bootstrapped 95% confidence intervals. Predictors of human chorionic gonadotropin increase were analyzed using multivariable linear regression. Results: Among 71 women, two (2.8%) were pregnant, 46 (64.8%) potentially fertile, and 23 (32.4%) infertile. We observed human chorionic gonadotropin concentrations > 5 mIU/ml in 10 patients, which had a sensitivity of 100% (95% confidence interval: 100 to 100), a specificity of 86% (95% confidence interval: 77 to 94), a positive predictive value of 17% (95% confidence interval: 8 to 25) and a negative predictive value of 100% (95% confidence interval: 100 to 100) for the diagnosis of pregnancy. Using a cutoff > 14 mIU/ml for infertile patients or the exclusion of infertile patients increased specificity to 93% or 98%, respectively. The ideal cutoff was 25 mIU/ml (95% confidence interval: 17 to 33). Pregnancy and potential fertility, but not age, were independent predictors of human chorionic gonadotropin. Conclusion: Human chorionic gonadotropin is elevated > 5mIU/ml in 14.5% of non-pregnant dialysis patients of childbearing age. In potentially fertile women, this cutoff can be used to exclude pregnancy. In case of an unknown fertility status, the ideal human chorionic gonadotropin cutoff was 25 mIU/ml.

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“…The care of pregnant patients with GN requires coordination and planning with obstetrician-gynecologist (OB-GYN) and maternal fetal medicine, as detailed in the figure below (Figure GP8). 84,85 A review of women diagnosed with GN showed that many patients presented during pregnancy with complications, and this may be an opportunity for health care providers to act early in the disease process. 86…”

Section: Pregnancy and Reproductive Health In Women With Gnmentioning

confidence: 99%

Nephrotic syndrome in adults: symptoms and management

2021

Pharmaceutical Journal

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Focal segmental glomerulosclerosis in adults……………………………………………………… 190 Chapter 7. Infection-related glomerulonephritis……………………………………………………………….. 210 Chapter 8. Immunoglobulin and complement-mediated glomerular diseases with an MPGN pattern of injury……………………………………………………………………..……………………………………..

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Glomerular Disease in Women

Cited by 17 publications

References 122 publications

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Exclusion of pregnancy in dialysis patients: diagnostic performance of human chorionic gonadotropin

Nephrotic syndrome in adults: symptoms and management

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