Abstract: FR-PO0972
Pregnancy-Associated Changes in Kidney Function Among Women with CKD and Healthy Controls
Session Information
- Women's Health and Kidney Diseases
October 23, 2026 | Location: Exhibit Hall A, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Women's Health and Kidney Diseases
- 2100 Women's Health and Kidney Diseases
Authors
- Gimba, Michelle O., Johns Hopkins Medicine, Baltimore, Maryland, United States
- Srialluri, Nityasree, Johns Hopkins Medicine, Baltimore, Maryland, United States
Background
Pregnancy in women with chronic kidney disease (CKD) is associated with increased risk of renal dysfunction and adverse pregnancy outcomes. However, longitudinal changes in renal function and proteinuria across CKD stages remain incompletely characterized.
Methods
We conducted a retrospective cohort study of pregnant adult women followed at Johns Hopkins Hospital from January 2016 to January 2025. Participants were followed before, during, and up to 6 months postpartum. Women with pre-existing CKD were compared with controls without CKD or CKD-related comorbidities. Demographics, CKD stage, laboratory values, comorbidities, acute kidney injury (AKI), and pregnancy outcomes were captured and analyzed using descriptive statistics and regression modeling in R.
Results
Eighty-four participants were included: 32 with CKD and 52 controls. The mean age was 30.7 years in the CKD group and 30.9 years in the control group. Most CKD participants had stage 1–2 disease (59.4%), followed by stages 4-5 (18.7%) and stage 3 (15.6%). Hypertension was the most common comorbidity (46.9%). In the CKD cohort, baseline Cr was 1.2±0.9 mg/dL, eGFR 81.6±31.3 mL/min/1.73 m^2, and UPCR 429 [150–1508] mg/g.
Women with CKD had higher rates of AKI and preterm birth, particularly in the setting of preeclampsia. Moderate and severe CKD were associated with significantly higher UPCR levels compared with controls (p=0.045 and p=0.003, respectively). Longitudinal analyses demonstrated persistently elevated proteinuria in stage 3 CKD extending to 12 months postpartum (p=0.021). Stages 3–5 CKD were also associated with progressive declines in eGFR during and after pregnancy. Older age, higher BMI, and lower baseline eGFR were associated with a greater risk of renal function decline postpartum.
Conclusion
Pregnant women with pre-existing CKD experienced greater proteinuria, worsening renal function, and higher rates of adverse pregnancy outcomes compared with controls. Higher baseline CKD stage was associated with sustained postpartum proteinuria and progressive decline in kidney function. These findings support closer longitudinal monitoring of pregnant women with CKD, particularly those with advanced disease. Given the study’s small sample size and retrospective nature, future research will involve a multi-center and longer study design to better inform pregnancy’s impact on CKD over a longer period.
Funding
- NIDDK Support