Kidney function, blood pressure and proteinuria were associated with pregnancy outcomes of pregnant women with chronic kidney disease: a single-center, retrospective study in the Asian population

被引：5

作者：

Kumakura, Satoshi ^{[1
,2
]}

Okamoto, Koji ^{[1
]}

Takeuchi, Saeko ^{[1
]}

Yoshida, Mai ^{[1
]}

Nakamichi, Takashi ^{[3
]}

Nagasawa, Tasuku ^{[1
]}

Fujikura, Emi ^{[2
]}

Yamamoto, Tae ^{[4
]}

Saito, Masatoshi ^{[5
]}

Hanita, Takushi ^{[6
]}

Satoh, Michihiro ^{[7
]}

Sato, Hiroshi ^{[1
,8
]}

Ito, Sadayoshi ^{[1
,9
]}

Harigae, Hideo ^{[1
]}

Miyazaki, Mariko ^{[1
,2
]}

机构：

[1] Tohoku Univ, Grad Sch Med, Div Nephrol Endocrinol & Vasc Med, Aoba Ku, 2-1 Seiryo Machi, Sendai, Miyagi 9808575, Japan

[2] Tohoku Univ Hosp, Div Blood Purificat, Aoba Ku, 1-1 Seiryo Machi, Sendai, Miyagi 9808575, Japan

[3] Ishinomaki Red Cross Hosp, Dept Nephrol, 71 Hebita Aza Nishinomichishita, Ishinomaki, Miyagi 9868255, Japan

[4] Sendai City Hosp, Dept Internal Med, Aoba Ku, 1-1-1 Asuto Nagamachi, Sendai, Miyagi 9808502, Japan

[5] Tohoku Univ, Grad Sch Med, Dept Gynecol & Obstet, Aoba Ku, 2-1 Seiryo Machi, Sendai, Miyagi 9808575, Japan

[6] Tohoku Univ, Grad Sch Med, Dept Pediat, Aoba Ku, 2-1 Seiryo Machi, Sendai, Miyagi 9808575, Japan

[7] Tohoku Med & Pharmaceut Univ, Fac Med, Div Publ Hlth Hyg & Epidemiol, Miyagino Ku, 1-15-1 Fukumuro, Sendai, Miyagi 9838536, Japan

[8] JR Sendai Hosp, Dept Internal Med, Aoba Ku, 1-1-5 Itsutsubashi, Sendai, Miyagi 9800022, Japan

[9] Katta Gen Hosp, Dept Med, 36 Fukuokakuramoto Aza Shimookibara, Shiroishi, Miyagi 9890231, Japan

来源：

CLINICAL AND EXPERIMENTAL NEPHROLOGY | 2020年 / 24卷 / 06期

关键词：

Chronic kidney disease; Pregnancy; Severe adverse events; Low birth weight; Small for gestational age; RISK;

D O I：

10.1007/s10157-020-01865-0

中图分类号：

R5 [内科学]; R69 [泌尿科学（泌尿生殖系疾病）];

学科分类号：

1002 ; 100201 ;

摘要：

Background Studies among pregnant Asian women with chronic kidney disease (CKD) have not been widely performed; therefore, clinical criteria for these patients have not been well established. Methods We conducted a retrospective study among pregnant women with CKD who received prenatal care at our institution for 8 consecutive years. Primary outcome was the development of severe adverse events (SAEs). We analyzed correlations between primary outcome and CKD parameters [age, body mass index (BMI), estimated glomerular filtration rate (eGFR), urinary protein-creatinine ratio (UP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and not normal blood pressure (non-NBP)] at the time of referral. Secondary outcomes were low birth weight (LBW), preterm delivery (PreD), and small for gestational age (SGA). We divided into two categories, CKD stage G1, and G2 or higher according to eGFR, and proteinuria negative and proteinuria positive according to UP, respectively. Results We observed 89 pregnancies. SAE was observed in 28 pregnancies. In live birth cases, there were 28 PreD, 28 LBW and 13 SGA. Major SAEs included preeclampsia, superimposed preeclampsia, unscheduled cesarean section, neonatal intensive care unit admission, and fetal death. Stepwise logistic regression analysis selected eGFR (OR = 0.847, p = 0.026), SBP (OR = 1.897, p = 0.006) and proteinuria positive (OR = 2.96, p = 0.046) as the significant predictors of SAEs. There were no significant differences among the baseline characteristics stratified by SGA. Conclusions This is the first study to report pregnancy outcomes among Japanese non-disease-oriented patients with CKD. In Asians, especially in the Japanese population, kidney function, blood pressure and proteinuria might affect pregnancy outcomes.

引用

页码：547 / 556

页数：10