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Kidney Week

Abstract: TH-PO746

Maternal and Fetal Outcomes in Women with CKD Diagnosed During Pregnancy

Session Information

Category: Women’s Health and Kidney Diseases

  • 2000 Women’s Health and Kidney Diseases

Authors

  • Arellano-Mendez, Denisse, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, Mexico
  • Soto-Vargas, Javier, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, Mexico
  • Chavarria-Avila, Efrain, Universidad de Guadalajara, Guadalajara, Mexico
  • Jimenez Mejia, Carlos Daniel, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, Mexico
  • Márquez magaña, Isela, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, Mexico
  • Parra Michel, Renato, Universidad de Guadalajara, Centro Universitario de Ciencias de la Salud, Especialidad en nefrologia, Hospital General Regional No 46 del IMSS, Guadalajara, Mexico
Background

Diagnosis of Chronic Kidney Disease (CKD) during pregnancy, has increased in recent years. It is associated with worst outcomes for the mother and the baby. Mexico has one of the highest incidence of CKD, but, little is known about the impact of CKD in our population. The purpose of this work is to present the outcomes in a cohort of Mexican women with CKD diagnosed during pregnancy.

Methods

A prospective observational study, 32 pregnant women with CKD were included with quarterly follow-up until three months after delivery and were compared with 117 age matched pregnant woman without CKD for hypertensive disorders of pregnancy, gestational age, low birth weight, preterm delivery and relevant clinical kidney events.

Results

No differences were found in baseline characteristics except for the serum creatinine. Hypertension was associated with CKD (P=0.001). Women with CKD had a greater number of caesarean sections (P=0.001), and their babies had lower birth weight, gestational age, and preterm delivery (P=0.006, 0.001 and 0.007 respectively). During pregnancy three patients required renal replacement therapy (RRT), which started at 8.6±4.1 gestational weeks. Two of them continued in RRT after the delivery. Only 19 (59.4%) of CKD patients went to the follow-up, eight (66.7%) of 13 patients with a hypertensive disorder of pregnancy were classified as chronic hypertension, and nine (90%) of 10 patient had persistent proteinuria. No deaths were reported during the follow-up.

Conclusion

CKD is associated with worse maternal and fetal outcomes. In our country, it is necessary to implement strategies to allow diagnosis of CKD during or ideally before pregnancy, a close follow-up by nephrologist and evaluate the impact of its intervention in maternal and fetal outcomes.