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Pregnancy and Kidney Outcomes in Patients With IgA Nephropathy: A Cohort Study

Su, Xiaole, MD ; Lv, Jicheng, MD, PhD ; Liu, Youxia, MD ; Wang, Jinwei, PhD ; Ma, Xinxin, MD ; Shi, Sufang, MD ; Liu, Lijun, MD ; Zhang, Hong, MD

American journal of kidney diseases, 2017-08, Vol.70 (2), p.262-269 [Periódico revisado por pares]

United States: Elsevier Inc

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Título:
Pregnancy and Kidney Outcomes in Patients With IgA Nephropathy: A Cohort Study
Autor: Su, Xiaole, MD ; Lv, Jicheng, MD, PhD ; Liu, Youxia, MD ; Wang, Jinwei, PhD ; Ma, Xinxin, MD ; Shi, Sufang, MD ; Liu, Lijun, MD ; Zhang, Hong, MD
Assuntos: Adult ; Chronic kidney disease (CKD) ; CKD stage ; Cohort Studies ; Disease Progression ; estimated glomerular filtration rate (eGFR) ; Female ; fetal loss ; Glomerulonephritis, IGA - complications ; Humans ; hypertension ; immunoglobulin A nephropathy (IgAN) ; kidney disease outcomes ; kidney disease progression ; Nephrology ; Pregnancy ; Pregnancy Complications - etiology ; Pregnancy Outcome ; proteinuria ; Renal Insufficiency, Chronic - etiology ; Risk Factors ; severe pre-eclampsia ; Severity of Illness Index
É parte de: American journal of kidney diseases, 2017-08, Vol.70 (2), p.262-269
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SourceType-Scholarly Journals-1
ObjectType-Feature-2
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Descrição: Background The outcomes of pregnancy in immunoglobulin A nephropathy (IgAN) are controversial. This cohort study assessed the effects of pregnancy on kidney disease progression and risk factors for adverse pregnancy outcomes in patients with IgAN. Study Design A cohort study. Setting & Participants Women of child-bearing age with IgAN and minimum follow-up of 1 year after biopsy from December 2003 to September 2014. Predictors Pregnancy, treated as a time-dependent variable; baseline (at time of biopsy) estimated glomerular filtration rate (eGFR), proteinuria, blood pressure, and kidney pathology (Oxford MEST classification). Outcomes Kidney disease progression event, defined as 30% decline in eGFR or end-stage kidney disease; rate of eGFR decline; and adverse pregnancy outcomes, including severe preeclampsia and fetal loss. Results Of 413 patients enrolled, 266 (64.4%), 101 (24.5%), 40 (9.6%), and 6 (1.5%) had chronic kidney disease (CKD) stages 1, 2, 3, and 4, respectively. During follow-up, 104 had 116 pregnancies, of which 110 continued beyond week 20; 309 patients did not become pregnant. After adjustment for age, eGFR, mean arterial pressure, proteinuria, and pathology class at the time of biopsy, subsequent pregnancy among patients with CKD stages 3 to 4, but not CKD stages 1 to 2, was associated with faster eGFR decline (−7.44 vs −3.90 mL/min/1.73 m2 per year; P = 0.007) and increased incidence of kidney progression events (HR, 5.14; 95% CI, 1.16-22.74) compared with patients who did not become pregnant. Limitations Relatively small sample size and single-center experience. Conclusions Pregnancy accelerated kidney disease progression in women with IgAN and CKD stage 3, but not in those at stage 1 or 2.
Editor: United States: Elsevier Inc
Idioma: Inglês

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Pregnancy and Kidney Outcomes in Patients With IgA Nephropathy: A Cohort Study

Su, Xiaole, MD ; Lv, Jicheng, MD, PhD ; Liu, Youxia, MD ; Wang, Jinwei, PhD ; Ma, Xinxin, MD ; Shi, Sufang, MD ; Liu, Lijun, MD ; Zhang, Hong, MD

United States: Elsevier Inc

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