Abstract: PO2239
Maternal Health in Autosomal Dominant Tubulointerstitial Kidney Disease
Session Information
- Advances in Women's Health and Kidney Diseases
November 04, 2021 | Location: On-Demand, Virtual Only
Abstract Time: 10:00 AM - 12:00 PM
Category: Women’s Health and Kidney Diseases
- 2000 Women’s Health and Kidney Diseases
Authors
- Bowline, Isai G., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Bleyer, Anthony J., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Kidd, Kendrah O., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Williams, Adrienne H., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Connaughton, Dervla M., London Health Sciences Centre, London, Ontario, Canada
- Robins, Victoria C., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Taylor, Abbigail, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Martin, Lauren, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Kim, Alice, Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Langefeld, Carl D., Wake Forest University School of Medicine, Winston-Salem, North Carolina, United States
- Zivna, Martina, Univerzita Karlova 1 lekarska fakulta, Praha, Praha, Czechia
- Kmoch, Stanislav, Univerzita Karlova 1 lekarska fakulta, Praha, Praha, Czechia
Background
Autosomal dominant tubulointerstitial kidney disease due to MUC1 mutations (ADTKD-MUC1) and UMOD mutations (ADTKD-UMOD) are becoming increasingly recognized as causes of chronic kidney disease (CKD). Genetic testing allows women to determine if they are affected with these conditions, and data on the outcomes in pregnancy in ADTKD would be of great interest to them as they prepare for future pregnancies.
Methods
We surveyed women with ADTKD and genetically unaffected family regarding past pregnancy outcomes. We also analyzed survival to end-stage kidney disease (ESKD) according to number of pregnancies.
Results
We received completed standardized questionnaires surveys from 52 women with ADTKD-MUC1 (113 pregnancies), 74 women with ADTKD-UMOD (136 pregnancies), and 35 genetically unaffected women (64 pregnancies). At the time of pregnancy, only 16.5% of genetically affected women were aware that they had ADTKD. Results are summarized in Table 1. There was a nonstatistical increase in HTN and hospitalization for HTN. 10% of births to affected mothers were premature vs. 0% in unaffecteds (p<0.01); 12% of babies required a NICU stay vs. 6% in unaffecteds (p=0.06), but child outcomes were good. Survival analysis showed no statistical differences in age to ESRD based on number of pregnancies for affected women.
Conclusion
Patients with ADTKD had an increased prevalence of hypertension, anemia, and early delivery than controls, but overall pregnancy outcomes were good for mother and child. More information is needed on changes in glomerular filtration rate with pregnancy in ADTKD.
Characteristics and Pregnancy Complications Reported.
| Characteristic | ADTKD-MUC1 | ADTKD-UMOD | ADTKD-MUC1 and ADTKD-UMOD | Unaffected | p-value with individual as cluster |
| Individuals (n) | 35 | 50 | 85 | 23 | |
| Pregnancies (n) | 74 | 90 | 164 | 50 | |
| Age during pregnancy | 28.3±4.8 (n=73) | 27.0±4.8 (n=88) | 27.6±4.8 (n=161) | 29.3±4.1 (n=50) | 0.032 |
| High blood pressure during pregnancy | 8 (11%) | 22 (24%) | 30 (18%) | 6 (12%) | 0.54 |
| New onset high blood pressure | 6 (8%) | 17 (19%) | 23 (14%) | 6 (12%) | 0.71 |
| Hospitalized for hypertension | 3 (4%) | 9 (10%) | 12 (7%) | 1 (2%) | 0.13 |
| Anemia | 10 (14%) | 9 (10%) | 19 (12%) | 1 (2%) | 0.058 |
| New anemia | 8 (11%) | 4 (4%) | 12 (7%) | 1 (2%) | 0.10 |
| Premature (<37 weeks) | 8 (11%) | 10 (11%) | 16 (10%) | 0 | < 0.0001 |
| Cesarean section | 14 (19%) | 17 (19%) | 31 (19%) | 19 (38%) | 0.061 |
| Neonatal intensive care admission | 9 (13%) | 10 (11%) | 19 (12%) | 3 (6%) | 0.25 |
Funding
- Private Foundation Support