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大学・研究所にある論文を検索できる 「Kidney function, blood pressure and proteinuria were associated with pregnancy outcomes of pregnant women with chronic kidney disease: a single-center, retrospective study in the Asian population」の論文概要。リケラボ論文検索は、全国の大学リポジトリにある学位論文・教授論文を一括検索できる論文検索サービスです。
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Kidney function, blood pressure and proteinuria were associated with pregnancy outcomes of pregnant women with chronic kidney disease: a single-center, retrospective study in the Asian population

Satoshi Kumakura Koji Okamoto Saeko Takeuchi Mai Yoshida Takashi Nakamichi Tasuku Nagasawa Emi Fujikura Tae Yamamoto Masatoshi Saito Takushi Hanita Michihiro Satoh Hiroshi Sato Sadayoshi Ito Hideo Harigae Mariko Miyazaki 東北大学 DOI:10.1007/s10157-020-01865-0

2020.03.11

概要

[Background] Studies among pregnant Asian women with chronic kidney disease (CKD) have not been widely performed; therefore, clinical criteria for these patients have not been well established.

[Methods] We conducted a retrospective study among pregnant women with CKD who received prenatal care at our institution for eight consecutive years. Primary outcome was the development of severe adverse events (SAEs). We analyzed correlations between primary outcome and CKD parameters (age, body mass index [BMI], estimated glomerular filtration rate [eGFR], urinary protein-creatinine ratio [UP], systolic blood pressure [SBP], diastolic blood pressure [DBP], and not normal blood pressure [non-NBP]) at the time of referral. Secondary outcomes were low birth weight (LBW), preterm delivery (PreD), and small for gestational age (SGA). We divided into two categories, CKD stage G1, and G2 or higher according to eGFR, and proteinuria negative and proteinuria positive according to UP, respectively.

[Results] We observed 89 pregnancies. SAE was observed in 28 pregnancies. In live birth cases, there were 28 PreD, 28 LBW and 13 SGA. Major SAEs included preeclampsia, superimposed preeclampsia, unscheduled cesarean section, neonatal intensive care unit admission, and fetal death. Stepwise logistic regression analysis selected eGFR (OR=0.847, p=0.026), SBP (OR=1.897, p=0.006) and proteinuria positive (OR=2.96, p=0.046) as the significant predictors of SAEs. There were no significant differences among the baseline characteristics stratified by SGA.

[Conclusions] This is the first study to report pregnancy outcomes among Japanese non-disease-oriented patients with CKD. In Asians, especially in the Japanese population, kidney function, blood pressure and proteinuria might affect pregnancy outcomes.

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