Renal disease in women with severe preeclampsia or gestational proteinuria
Section snippets
Materials and methods
Preeclampsia was diagnosed according to the criteria established by the National High Blood Pressure Education Program Working Group.8 Proteinuria was defined as excretion exceeding 300 mg in a 24-hour urine collection, measured by the pyrogallol red method,9 or in some outpatients, a concentration of 30 mg/dL (1+ on dipstick) or more in a random urine specimen that is usually correlative.8 Severe preeclampsia was defined as sustained hypertension exceeding 160 mmHg systolic or 110 mmHg
Results
One woman had transient macrohematuria after biopsy. No others had any complications. Nineteen of 86 women (22.1%, 95% CI 13.9%, 32.3%) had underlying renal disease. Histologic diagnoses of renal diseases were IgA nephropathy (n = 12), non-IgA nephropathy (n = 3), minimal change (n = 2), interstitial nephritis (n = 1), and benign nephrosclerosis (n = 1). Twelve of 19 women (63.2%) with renal disease and 50 of 67 (74.6%) without were nulliparous (statistically not significant). Nine of the 19
Discussion
Our rate of underlying renal disease was 22.1%, a figure compatible with some studies5, 11 but lower than others.3, 6, 7 That discrepancy should not be because of characteristics of our patient population because the rate was lowered to 12.1% after the subjects were restricted to those with severe preeclampsia. Therefore, extremely high rates of underlying renal disease (65.0% in early-onset preeclampsia3 and 71.7%6) seem to appear in a selected population, perhaps relating to the referral
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Factors related to deterioration of renal function after singleton delivery in pregnant women with chronic kidney disease
2016, Taiwanese Journal of Obstetrics and GynecologyCitation Excerpt :Stages 3–5 (GFR < 60 mL/min/1.73 m2) affect approximately one in 150 women of childbearing age, but because of reduced fertility and an increased rate of early miscarriage, pregnancy in these women is less common [2]. Pregnancy in women with CKD is considered to be high risk and the knowledge of this risk guides patient counseling and follow-up [3–9]. For example, Fink et al [5] concluded that women with renal disease were at an increased risk of preeclampsia [odds ratio (OR) 7.2, 95% confidence interval (CI) 4.2–12.5], preterm labor (PTL; OR 7.9, 95% CI 1.9–32.6), dysfunctional labor (OR 3.6, 95% CI 1.1–11.5), and cesarean section (OR 3.1, 95% CI 2.0–4.8).
Preeclampsia and Hypertensive Disorders
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2013, Kidney International