Abstract: SA-PO417

Association of Estimated Glomerular Filtration Rate and Gestational Complications

Session Information

Category: Chronic Kidney Disease (Non-Dialysis)

  • 302 CKD: Estimating Equations, Incidence, Prevalence, Special Populations

Authors

  • Park, Sehoon, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Chin, Ho Jun, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
  • Na, Ki Young, Seoul National University Bundang Hospital, Seong nam, Korea (the Republic of)
  • Kim, Dong Ki, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Kim, Yon Su, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
  • Lee, Hajeong, Seoul National University Hospital, Jongno-gu, SEOUL, Korea (the Republic of)
Background

Glomerular filtration rate elevation represents the intrarenal hemodynamic changes in pregnant women, yet, estimated glomerular filtration rate (eGFR) during gestation and its association with pregnancy outcomes remains to be investigated.

Methods

We collected pregnancy cases in two tertiary teaching hospitals in Korea from 2001 to 2015. With eGFR during pregnancy, estimated by CKD-EPI method, we calculated time-averaged eGFR considering the value as a time-dependent variable. Adverse pregnancy outcome was composition of preterm birth, low birth weight and preeclampsia.

Results

Among total of 12,900 mothers, a number of 4,028 (31.2%) mothers experienced composite adverse pregnancy outcomes. Gestational eGFR showed a non-linear U-shaped association with the risk of gestational complication, which was most prominent with the midterm eGFR values. The adjusted odds ratio (aOR) and associated 95% confidence interval of an adverse pregnancy outcome for eGFR levels below and above the reference level of 120–150 mL/min/1.73 m2 were as follows: ≥150 mL/min/1.73 m2, aOR 1.86 (1.56-2.22), P<0.001; 90–120 mL/min/1.73 m2, aOR 1.18 (1.06-1.31), P=0.003; and 60–90 mL/min/1.73 m2, aOR 1.72 (1.12-2.65), P=0.014. Moreover, gestational eGFR additively elevated power to predict gestational complications [AUROC with eGFR 0.733 (0.717-0.740) .vs AUROC without eGFR 0.728 (0.722-0.744), P for AUROC comparison = 0.006].

Conclusion

We demonstrated a non-linear, U-shaped relationship between eGFR during gestation and the risk of adverse pregnancy outcome. Appropriate interpretation of eGFR values in pregnancy might be helpful for risk prediction of gestational complications.