The children of dialysis: live-born babies from on-dialysis mothers in Italy--an epidemiological perspective comparing dialysis, kidney transplantation and the overall population

Piccoli, G; Cabiddu, Gianfranca; Daidone, Giuseppe; Guzzo, Gabriella; Maxia, Stefania; Ciniglio, I.; Postorino, Valentina; Loi, Valentina; Ghiotto, Sara; Nichelatti, Michele; Attini, Rossella; Coscia, Alessandra; Postorino, Maurizio; Pani, Antonello; Castellino, Santina; Gernone, Giuseppe; Calabria, S.; Galliani, Marco; Tullio, Massimo Di; Fersini, S.; Chiappini, Maria Grazia; Proietti, Elena; Saffiotti, S.; Brunati, C; Montoli, Alberto; Esposito, Ciro; Montagna, G.; Salvatore, Teresa; Amatruda, O.; Casiraghi, E.; Pieruzzi, Federico; Benedetto, A. Di; Alfisi, G.; Monique, B.; Lévêque, Alain; Giofre, F.; Alati, Giovanni; Lombardi, Lucia

doi:10.1093/ndt/gfu092

Cited by 100 publications

(87 citation statements)

References 33 publications

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“…During pregnancy, 11 women needed antihypertensive treatment throughout it and one of them used only late in pregnancy by the occurrence of preeclampsia. An Italian series that followed 23 women found similar results with half of the patients being hypertensive at the beginning of pregnancy (12/22 with available data), and 14/22 were hypertensive in pregnancy and throughout this study there was even a maternal death from cerebral hemorrhage (1 year after delivery) 11 .…”

Section: Discussionsupporting

confidence: 77%

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Pregnancy in women undergoing hemodialysis: case series in a Southeast Brazilian reference center

Suarez¹,

Costa²,

Parpinelli³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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PURPOSE: To describe maternal and neonatal outcomes in pregnant women undergoing hemodialysis in a referral center in Brazilian Southeast side. METHODS: Retrospective and descriptive study, with chart review of all pregnancies undergoing hemodialysis that were followed-up at an outpatient clinic of high-risk prenatal care in Southeast Brazil. RESULTS: Among the 16 women identified, 2 were excluded due to follow-up loss. In 14 women described, hypertension was the most frequent cause of chronic renal failure (half of cases). The majority (71.4%) had performed hemodialysis treatment for more than one year and all of them underwent 5 to 6 hemodialysis sessions per week. Eleven participants had chronic hypertension, 1 of which was also diabetic, and 6 of them were smokers. Regarding pregnancy complications, 1 of the hypertensive women developed malignant hypertension (with fetal growth restriction and preterm delivery at 29 weeks), 2 had acute pulmonary edema and 2 had abruption placenta. The mode of delivery was cesarean section in 9 women (64.3%). All neonates had Apgar score at five minutes above 7. CONCLUSIONS: To improve perinatal and maternal outcomes of women undergoing hemodialysis, it is important to ensure multidisciplinary approach in referral center, strict control of serum urea, hemoglobin and maternal blood pressure, as well as close monitoring of fetal well-being and maternal morbidities. Another important strategy is suitable guidance for contraception in these women. ResumoOBJETIVOS: Descrever os resultados maternos e neonatais de mulheres grávidas que estavam em tratamento de hemodiálise em um centro de referência no Sudeste brasileiro. MÉTODOS: Estudo retrospectivo e descritivo, com revisão de prontuários de todas as gestações em hemodiálise, acompanhadas no pré-natal especializado da região Sudeste do Brasil. RESULTADOS: Entre as 16 mulheres identificadas, 2 foram excluídas devido à perda de seguimento. Das 14 descritas, a hipertensão foi a causa mais frequente de insuficiência renal crônica (50% dos casos). A maioria (71,4%) realizava tratamento de hemodiálise há mais de um ano e todas elas foram submetidas a 5 ou 6 sessões por semana. Onze mulheres tinham hipertensão crônica, 1 das quais também era diabética, e 6 eram fumantes. Em relação às complicações da gravidez, 1 das mulheres hipertensas desenvolveu hipertensão maligna (com restrição de crescimento fetal e parto prematuro com 29 semanas), 2 tiveram edema pulmonar agudo e 2 apresentaram descolamento prematuro de placenta. O tipo de parto foi cesariana em 9 mulheres (64,3%). Todos os recém-nascidos tiveram Apgar aos cinco minutos maior que 7. CONCLUSÕES: Para melhorar os resultados perinatais e maternos de mulheres em hemodiálise, é importante ter uma abordagem multidisciplinar em centro de referência, um controle rigoroso da uremia, hemoglobina e pressão arterial materna, bem como acompanhar de perto o bem-estar fetal e a morbidade materna. Outra estratégia importante é a orientação adequada para contracepção nessas mulheres.Obste...

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Section: Discussionsupporting

confidence: 77%

“…In addition, regarding prematurity, which is the most relevant neonatal complication among women with CKD undergoing hemodialysis, the Italian series found 19/21 preterm, being 7/21 below 34 weeks, average weight and gestational age of the newborns were also worse than those found in our study 11 .…”

Section: Discussioncontrasting

confidence: 71%

Pregnancy in women undergoing hemodialysis: case series in a Southeast Brazilian reference center

Suarez¹,

Costa²,

Parpinelli³

et al. 2015

Rev. Bras. Ginecol. Obstet.

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“…Данные, полученные в Европе и Австралии, указывают, что между женщинами с трансплан-тированной почкой и общей популяцией имеется соотношение 1:10, такое же соотношение между женщинами на диализе и женщинами с трансплан-тированной почкой (вероятность забеременеть у женщин на диализе составляет 1:100 по отноше-нию к общей популяции) [52,53]. Тем не менее пер-вые единичные случаи успешной беременности на диализе описаны еще в 1970-е гг., а в новом тысяче-летии возможность беременности на диализе стала общепризнанной [8,54,55].…”

Section: диализ и трансплантацияunclassified

What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman’s Day

et al. 2018

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“…The incidence of PE, compared to the general population) (52,53). The first sporadic cases of successful pregnancy on dialysis were described in the 70s, but in the new millennium this became an acknowledged real clinical possibility (8,54,55).…”

Section: Pregnancymentioning

confidence: 99%

Untitled

2018

Turk Neph Dial Transpl

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Chronic Kidney Disease affects approximately 10% of the world's adult population: it is within the top 20 causes of death worldwide, and its impact on patients and their families can be devastating. World Kidney Day and International Women's Day in 2018 coincide, thus offering an opportunity to reflect on the importance of women's health and specifically their kidney health, on the community, and the next generations, as well as to strive to be more curious about the unique aspects of kidney disease in women so that we may apply those learnings more broadly.Girls and women, who make up approximately 50% of the world's population, are important contributors to society and their families. Gender differences continue to exist around the world in access to education, medical care, and participation in clinical studies. Pregnancy is a unique state for women, offering an opportunity for diagnosis of kidney disease, but also a state where acute and chronic kidney diseases may manifest, and which may impact future generations with respect to kidney health. There are various autoimmune and other conditions that are more likely to impact women with profound consequences for child bearing, and on the fetus. Women have different complications on dialysis than men, and are more likely to be donors than recipients of kidney transplants.In this editorial, we focus on what we do and do not know about women, kidney health, and kidney disease, and what we might learn in the future to improve outcomes worldwide. KEY WORDS:Women, Access to care, Kidney health, Acute and chronic kidney disease, Inequities ÖZ Kronik Böbrek Hastalığı dünyadaki erişkin popülasyonun yaklaşık %10'unu etkiler: dünya çapında ölümün en sık görülen 20 nedeninden biridir ve hastalar ile aileleri üzerinde çok ciddi etkileri olabilir. Dünya Böbrek Günü ve Uluslararası Kadınlar Günü 2018 yılında aynı güne denk gelmiştir. Böylece kadın sağlığı ve özellikle böbrek sağlığının toplum ve sonraki nesiller üzerindeki önemini düşünmek, öğrendiklerimizi daha geniş bir şekilde uygulayabilmek için böbrek hastalığının benzersiz yönleri konusunda daha meraklı olmaya çalışmak için bir fırsat sunmaktadır.Dünya nüfusunun yaklaşık %50'sini oluşturan kızlar ve kadınlar toplum ve ailelerine önemli katkılar yaparlar. Dünya çapında eğitime erişim, tıbbi bakım ve klinik çalışmalara katılmada cinsiyetle ilgili farklılıklar bulunmaya devam etmektedir. Hamilelik kadınlar için eşsiz bir dönemdir ve böbrek hastalığına tanı konması fırsatı yaratır ama aynı zamanda böbrek sağlığı açısından gelecek nesilleri etkileyebilecek akut ve kronik böbrek hastalıklarının ortaya çıkabileceği bir durumdur. Kadınları etkilemesi daha olası olan ve çocuk sahibi olma ve fetus üzerinde çok önemli sonuçlar doğurabilecek çeşitli otoimmün ve başka hastalıklar bulunmaktadır. Kadınların diyaliz komplikasyonları erkeklerden farklıdır ve böbrek naklinde alıcı olmak yerine verici olma olasılıkları daha yüksektir.Bu editör yazısında kadınlar, böbrek sağlığı ve böbrek hastalığı hakkında bildiklerimiz ve bilmed...

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The children of dialysis: live-born babies from on-dialysis mothers in Italy--an epidemiological perspective comparing dialysis, kidney transplantation and the overall population

Cited by 100 publications

References 33 publications

Pregnancy in women undergoing hemodialysis: case series in a Southeast Brazilian reference center

Pregnancy in women undergoing hemodialysis: case series in a Southeast Brazilian reference center

What we do and do not know about women and kidney diseases; questions unanswered and answers unquestioned: Reflection on World Kidney Day and International Woman’s Day

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