Pregnancy in Chronic Kidney Disease: questions and answers in a changing panorama

Piccoli, Giorgina Barbara; Cabiddu, Gianfranca; Attini, Rossella; Vigotti, Federica Neve; Fassio, Federica; Rolfo, Alessandro; Giuffrida, Domenica; Pani, Antonello; Gaglioti, P.; Todros, Tullia

doi:10.1016/j.bpobgyn.2015.02.005

Cited by 45 publications

(36 citation statements)

References 98 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…As a consequence, PE definition in the context of chronic hypertension or CKD is particularly difficult, reflecting a complex relationship with pre-existing disease [47][48][49][50]. Indeed, while some Authors use the generic term of PE also in the setting of CKD and chronic hypertension, others prefer the term "placental dysfunction", to identify the onset or the worsening of hypertension or proteinuria in CKD pregnancies [50][51][52][53].…”

Section: Introductionmentioning

confidence: 94%

“…In fact, the three main disease markers (hypertension, proteinuria and kidney function impairment) are the same for PE and CKD, and in both conditions they may show different patterns of onset, from slowly progressive to stormy [47][48][49][50].…”

Section: Introductionmentioning

confidence: 96%

“…Indeed, while some Authors use the generic term of PE also in the setting of CKD and chronic hypertension, others prefer the term "placental dysfunction", to identify the onset or the worsening of hypertension or proteinuria in CKD pregnancies [50][51][52][53].…”

Section: Introductionmentioning

confidence: 98%

“…In pregnancy, however, diagnosis may be needed to optimize the clinical management, since a longer-waiting approach is possible in CKD, on the account of the lesser degree of placental involvement [47][48][49][50].…”

Section: Introductionmentioning

confidence: 98%

See 3 more Smart Citations

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Piccoli

Cabiddu

Castellino³

et al. 2017

J Nephrol

Self Cite

View full text Add to dashboard Cite

Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide. The increased awareness of the role of chronic kidney disease in pregnancy, complicating up to 3% of pregnancies, and the knowledge that PE is associated with an increased risk for development of CKD later in life have recently increased the interest and redesigned the role of the nephrologists in this context. However, while the heterogeneous definitions of PE, its recent reclassification, an emerging role for biochemical biomarkers, the growing body of epidemiological data and the new potential therapeutic interventions lead to counsel long-term follow-up, the lack of resources for chronic patients and the increasing costs of care limit the potential for preventive actions, and suggest tailoring specific interventional strategies. The aim of the present position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature and to try to identify theoretical and pragmatic bases for an agreed management of PE in the nephrological setting, with particular attention to the prevention of the syndrome (recurrent PE, presence of baseline CKD) and to the organization of the postpartum follow-up.

show abstract

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

Piccoli

Cabiddu

Castellino³

et al. 2017

J Nephrol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Despite the fact that there are several recent reviews on pregnancy in CKD, patients usually have different kidney and pregnancy outcomes, which could be explained by different types of baseline renal diseases, CKD stages, the presence of hypertension (HTN) and proteinuria [13- [14,17,18] . It underlines the importance of defining common profiles and of focusing on a specific renal disease.…”

Section: Discussionmentioning

confidence: 99%

A Systematic Review and Meta-Analysis of Kidney and Pregnancy Outcomes in IgA Nephropathy

Liu¹,

Zheng

et al. 2016

Am J Nephrol

View full text Add to dashboard Cite

Background: The outcomes of pregnancy in immunoglobulin A nephropathy (IgAN) remain controversial. We sought to evaluate the effect of pregnancy on the progression of IgAN as well as the impact of IgAN on pregnancy outcomes. Methods: We systematically searched MEDLINE, Embase for cohort or case-control studies. OR reductions were calculated with a random-effects model, and kidney outcomes and adverse pregnancy events were analyzed. Results: Our literature search returned 652 relevant articles; 4 studies were included, providing data of 376 pregnancies in 273 patients with IgAN and that of 241 IgAN who did not become pregnant. Four hundred sixty seven patients with chronic kidney disease stages 1-2 were included. Pregnancy in patients with IgAN did not increase the risk of adverse renal events including doubling of serum creatinine, 50% decline in glomerular filtration rate (GFR) and end-stage kidney disease (OR 0.97, 95% CI 0.55-1.70; p = 0.90; I² = 0.0%, p = 0.79). There was no significant difference in the change in estimated GFR at the end of follow-up in the pregnant and non-pregnant groups (weighted mean difference 0.1 ml/min/1.73 m² (95% CI -4.85 to 5.04 ml/min/1.73 m²), p = 0.97; I² = 0%, p = 0.95). Women with IgAN had high rates of infant loss (12.2, 7.4-19.4%), preterm delivery (8.5, 5.9-12.1%), low birth weight (9.5, 6.7-13.3%), and preeclampsia/severe preeclampsia (7.3, 4.9-10.6%). Conclusions: Pregnancy in IgAN patients with preserved kidney function did not accelerate deterioration of renal function. But pregnant women with IgAN are at higher risk of pregnancy complications.

show abstract

Pregnancy

Irish

Jesudason

2022

Evidence‐Based Nephrology

View full text Add to dashboard Cite

Pregnancy in Chronic Kidney Disease: questions and answers in a changing panorama

Cited by 45 publications

References 98 publications

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

A Systematic Review and Meta-Analysis of Kidney and Pregnancy Outcomes in IgA Nephropathy

Pregnancy

Contact Info

Product

Resources

About