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

Satoshi Kumakura, Koji Okamoto, Saeko Takeuchi, Mai Yoshida, Takashi Nakamichi, Tasuku Nagasawa, Emi Fujikura, Tae Yamamoto, Masatoshi Saito, Takushi Hanita, Michihiro Satoh, Hiroshi Sato, Sadayoshi Ito, Hideo Harigae, Mariko Miyazaki

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)547-556
Number of pages10
JournalClinical and experimental nephrology
Volume24
Issue number6
DOIs
Publication statusPublished - 2020 Jun 1

Keywords

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

ASJC Scopus subject areas

  • Physiology
  • Nephrology
  • Physiology (medical)

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