Pregnancy in Chronic Kidney Disease: Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Different CKD Stages and Phases
department or school: Medicine, Faculty of
department or school: Non UBC
department or school: Medicine, Department of
data provider: DSpace
identifier citation: Journal of Clinical Medicine 7 (11): 415 (2018)
creator: Piccoli, Giorgina
creator: Zakharova, Elena
creator: Attini, Rossella
creator: Ibarra Hernandez, Margarita
creator: Orozco Guillien, Alejandra
creator: Alrukhaimi, Mona
creator: Liu, Zhi-Hong
creator: Ashuntantang, Gloria
creator: Covella, Bianca
creator: Cabiddu, Gianfranca
creator: Li, Philip Kam Tao
creator: Garcia-Garcia, Guillermo
creator: Levin, A. (Adeera)
issued: 2019-06-13T15:46:29Z
issued: 2018-11-05
description: Pregnancy is possible in all phases of chronic kidney disease (CKD), but its management may be difficult and the outcomes are not the same as in the overall population. The prevalence of CKD in pregnancy is estimated at about 3%, as high as that of pre-eclampsia (PE), a better-acknowledged risk for adverse pregnancy outcomes. When CKD is known, pregnancy should be considered as high risk and followed accordingly; furthermore, since CKD is often asymptomatic, pregnant women should be screened for the presence of CKD, allowing better management of pregnancy, and timely treatment after pregnancy. The differential diagnosis between CKD and PE is sometimes difficult, but making it may be important for pregnancy management. Pregnancy is possible, even if at high risk for complications, including preterm delivery and intrauterine growth restriction, superimposed PE, and pregnancy-induced hypertension. Results in all phases are strictly dependent upon the socio-sanitary system and the availability of renal and obstetric care and, especially for preterm children, of intensive care units. Women on dialysis should be aware of the possibility of conceiving and having a successful pregnancy, and intensive dialysis (up to daily, long-hours dialysis) is the clinical choice allowing the best results. Such a choice may, however, need adaptation where access to dialysis is limited or distances are prohibitive. After kidney transplantation, pregnancies should be followed up with great attention, to minimize the risks for mother, child, and for the graft. A research agenda supporting international comparisons is highly needed to ameliorate or provide knowledge on specific kidney diseases and to develop context-adapted treatment strategies to improve pregnancy outcomes in CKD women.
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/70635
note: Journal ofClinical MedicineReviewPregnancy in Chronic Kidney Disease: Need forHigher Awareness. A Pragmatic Review Focused onWhat Could Be Improved in the Different CKDStages and PhasesGiorgina B. Piccoli 1,2,* , Elena Zakharova 3,4,5, Rossella Attini 6, Margarita Ibarra Hernandez 7,Alejandra Orozco Guillien 8, Mona Alrukhaimi 9, Zhi-Hong Liu 10, Gloria Ashuntantang 11,Bianca Covella 2, Gianfranca Cabiddu 12 , Philip Kam Tao Li 13, Guillermo Garcia-Garcia 7and Adeera Levin 141 Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy2 Néphrologie, Centre Hospitalier Le Mans, 72000 Le Mans, France; biancacovella@gmail.com3 Nephrology, Moscow City Hospital n.a. S.P. Botkin, 101000 Moscow, Russia; helena.zakharova@gmail.com4 Nephrology, Moscow State University of Medicine and Dentistry, 101000 Moscow, Russia5 Nephrology, Russian Medical Academy of Continuous Professional Education, 101000 Moscow, Russia6 Obstetrics, Department of Surgery, University of Torino, 10100 Torino, Italy; rossella.attini@gmail.com7 Nephrology Service, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, University of GuadalajaraHealth Sciences Center, Guadalajara, Jal 44100, Mexico; maribaher@yahoo.es (M.I.-H.);ggarcia1952@gmail.com (G.G.-G.)8 Instituto Nacional de Perinatologia, Mexico D.F. 01020, Mexico; ale_gaba@hotmail.com9 Department of Medicine, Dubai Medical College, P.O. Box 20170, Dubai, UAE; mona_539@yahoo.co.uk10 National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School ofMedicine, Nanjing 210000, China; zhihong–liu@hotmail.com11 Yaounde General Hospital & Faculty of Medicine and Biomedical Sciences, University of Yaounde I,P.O. Box 337, Yaounde, Cameroon; maglo09@hotmail.com12 Nefrologia Ospedale Brotzu, 09100 Cagliari, Italy; gianfranca.cabiddu@tin.it13 Prince of Wales Hospital, Department of Medicine and Therapeutics, Chinese University of Hong Kong,Hong Kong; philipli@cuhk.edu.hk14 Department of Medicine, D…
has type: Article
is shown at: 10.14288/1.0379427
language: eng
peer review status: Reviewed
provider: Vancouver : University of British Columbia Library
publisher: Multidisciplinary Digital Publishing Institute
publisher DOI: 10.3390/jcm7110415
rights: CC BY 4.0
rights URI: https://creativecommons.org/licenses/by/4.0/
scholar level: Faculty
subject: Chronic kidney disease (CKD), dialysis
subject: Kidney transplantation
subject: Pregnancy
subject: Pregnancy complications
type: Text
identifier URI: http://hdl.handle.net/2429/70635