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Abstract: TH-PO760

Pregnancy History and Disease Progression Among Women Enrolled in Cure Glomerulopathy (CureGN)

Session Information

Category: Women's Health and Kidney Diseases

  • 2100 Women's Health and Kidney Diseases

Authors

  • Reynolds, Monica Lona, University of North Carolina System, Chapel Hill, North Carolina, United States
  • Oliverio, Andrea L., University of Michigan, Ann Arbor, Michigan, United States
  • Zee, Jarcy, University of Pennsylvania, Philadelphia, Pennsylvania, United States
  • Ayoub, Isabelle, The Ohio State University, Columbus, Ohio, United States
  • Almaani, Salem, The Ohio State University, Columbus, Ohio, United States
  • Rizk, Dana, The University of Alabama at Birmingham College of Arts and Sciences, Birmingham, Alabama, United States
  • O'Shaughnessy, Michelle M., University College Cork, Cork, Cork, Ireland
  • Hendren, Elizabeth M., Columbia University, New York, New York, United States
  • Vasylyeva, Tetyana L., Texas Tech University System, Amarillo, Texas, United States
  • Wadhwani, Shikha, Northwestern University, Evanston, Illinois, United States
  • Steinke, Julia M., Spectrum Health Helen DeVos Children's Hospital, Grand Rapids, Michigan, United States
  • Waldman, Meryl A., National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland, United States
  • Helmuth, Margaret, Arbor Research Collaborative for Health, Ann Arbor, Michigan, United States
  • Nester, Carla Marie, University of Iowa, Iowa City, Iowa, United States
  • Alachkar, Nada, Johns Hopkins University, Baltimore, Maryland, United States
  • Avila-Casado, Carmen, University of Toronto, Toronto, Ontario, Canada
  • Hladunewich, Michelle A., Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
  • Mariani, Laura H., University of Michigan, Ann Arbor, Michigan, United States
Background

Preeclampsia increases risk for future CKD, possibly through sustained endothelial and podocyte dysfunction. Utilizing CureGN, a longitudinal glomerular disease cohort study, we assessed if complicated pregnancy history was associated with disease progression.

Methods

Adult women were classified based on self-reported history of complicated pregnancy (worsening blood pressure, worsening kidney function, increased proteinuria, preeclampsia, eclampsia, or HELLP), pregnancy without these complications, or no pregnancy prior to CureGN enrollment. Linear mixed models assessed associations between complicated pregnancy history and eGFR trajectory as well as UPCR from enrollment.

Results

Of 780 women with median follow-up of 32 months, the adjusted eGFR decline [95% CI] was faster in women with a history of complicated pregnancy compared to those without complications or no pregnancy (-2.1 [-2.9, -1.4] vs -0.9 [-1.4, -0.5] and -0.7 [-1.3, -0.1] mL/min/1.73m2 per year, p = 0.01) (Figure). Proteinuria trend did not differ significantly by pregnancy history. Among women with complicated pregnancy (n=124), eGFR slope did not differ significantly by timing of first complicated pregnancy relative to GN diagnosis.

Conclusion

A history of complicated pregnancy, occurring at any length of time from GN diagnosis, was associated with faster eGFR decline following CureGN enrollment. A detailed obstetric history may inform counseling regarding disease progression in women with GN. Continued research is warranted to identify biological pathways between complicated pregnancy and progressive glomerular disease.

Predicted values of eGFR (95% CI) by pregnancy history from adjusted linear mixed model