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Abstract: FR-PO868

Kidney Hyperfiltration Is Associated with Pregnancy Outcome in Patients with CKD

Session Information

Category: Women's Health and Kidney Diseases

  • 2200 Women's Health and Kidney Diseases

Authors

  • Kitajima, Shinji, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Iwata, Yasunori, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Toyama, Tadashi, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Hara, Akinori, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Sakai, Norihiko, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Shimizu, Miho, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
  • Wada, Takashi, Kanazawa Daigaku Fuzoku Byoin, Kanazawa, Ishikawa, Japan
Background

While major population of chronic kidney disease (CKD) is older patients, some population of younger patients are also suffered from CKD. The increased risks of adverse pregnant outcomes were reported in CKD patients. In fact, the frequency of adverse pregnancy outcome is increased in accordance with the severity of kidney dysfunction. In healthy kidney, hemodynamics shifts to hyper-dynamic state during pregnancy. However, details of hemodynamics during pregnancy and its effects for pregnancy outcome are not clear in CKD patients. Therefore, we explored the association between kidney function and pregnancy outcome in CKD patients in this study.

Methods

We retrospectively enrolled 21 CKD patients with pregnancy. The patients visited or were admitted to the Department of Nephrology and Laboratory Medicine and/or Department of Obstetrics in Kanazawa University between 2004 and 2018. The association between kidney function, especially hyperfiltration during pregnancy and adverse pregnancy outcome was evaluated.

Results

The patients without adverse pregnancy complication showed higher eGFR than those with complication during pregnancy period. The increase of estimated glomerular filtration rate (eGFR) during pregnancy is associated with good pregnancy outcome in CKD patients(Fig.1). Even in patients with high eGFR in pre-pregnancy, the absence of increase of eGFR during pregnancy is associated with adverse pregnancy events.

Conclusion

The increase of eGFR during pregnancy was associated with good outcome in CKD patients. Further studies may raise the possibility that assessment of kidney function during pregnancy may be useful marker for the prediction of the pregnancy outcome in CKD patients.

The % increase of eGFR inversely correlated with the numbers of accumulated complications.