Academic Journal
Any reduction in maternal kidney mass makes a difference during pregnancy in gestational and fetal outcome
| العنوان: | Any reduction in maternal kidney mass makes a difference during pregnancy in gestational and fetal outcome |
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| المؤلفون: | Piccoli G. B., Attini R., Torreggiani M., Chatrenet A., Manzione A. M., Masturzo B., Casula V., Longhitano E., Dalmasso E., Biancone L., Pani A., Cabiddu G. |
| المساهمون: | Piccoli, G. B., Attini, R., Torreggiani, M., Chatrenet, A., Manzione, A. M., Masturzo, B., Casula, V., Longhitano, E., Dalmasso, E., Biancone, L., Pani, A., Cabiddu, G. |
| سنة النشر: | 2024 |
| المجموعة: | Università degli Studi di Cagliari: UNICA IRIS |
| مصطلحات موضوعية: | Chronic kidney disease, Fetal outcome, Maternal outcome, Pregnancy, Previous acute pyelonephriti, Solitary kidney, Tubulointerstitial nephropathies |
| الوصف: | Little is known about the effect tubulointerstitial nephropathies have in modulating maternal -fetal outcomes in pregnancy. Therefore, we analyzed the main outcomes of pregnancy in these women to gain a better understanding of the role of a reduction in maternal kidney mass. From the Torino Cagliari Observational Study (TOCOS) cohort, we selected 529 patients with a diagnosis of tubulointerstitial disease and focused on 421 patients with chronic kidney disease (CKD) stage 1, without hypertension but with proteinuria less than 0.5 g/day at referral. From a cohort of 2969 singleton deliveries from low-risk pregnancies followed in the same settings we selected a propensity score matched control cohort of 842 pregnancies match 2:1 for age, parity, body mass index, ethnicity, and origin. Time to delivery was signi ficantly shorter in the study cohort 38.0 (Quartile 1Quartile 3: 37.0-39.0) versus 39.0 (Q1 -Q3 38.0-40.0) weeks, with respect to controls. Incidence of delivery of less than 37 gestational weeks signi ficantly increased from controls (7.4%) to women with previous acute pyelonephritis (10.8%), other tubulointerstitial diseases (9.7%) and was the highest in patients with a single kidney (31.1%). Similarly, neonatal birthweight signi ficantly and progressively decreased from controls (3260 g [Q1 -Q3: 2980-3530]), previous acute pyelonephritis (3090 g [Q1 -Q3: 2868-3405], other tubulointerstitial diseases (3110 g [Q1 -Q3: 2840-3417]), and to solitary kidney (2910 g [Q1 -Q3: 2480-3240]). Risk of developing preeclampsia was signi ficantly higher in the CKD cohort (3.6% vs 1.7% in low-risk controls). Thus, even a small reduction in functional kidney mass, such as a pyelonephritic scar, is associated with a shorter duration of pregnancy and an increased risk of preterm delivery. The risk is proportional to the extent of parenchymal reduction and is highest in cases with a solitary kidney. |
| نوع الوثيقة: | article in journal/newspaper |
| اللغة: | English |
| Relation: | info:eu-repo/semantics/altIdentifier/pmid/38296027; info:eu-repo/semantics/altIdentifier/wos/WOS:001223532800001; volume:105; issue:4; firstpage:865; lastpage:876; numberofpages:12; journal:KIDNEY INTERNATIONAL; https://hdl.handle.net/11584/404924; info:eu-repo/semantics/altIdentifier/scopus/2-s2.0-85186077935 |
| DOI: | 10.1016/j.kint.2023.12.018 |
| الاتاحة: | https://hdl.handle.net/11584/404924 https://doi.org/10.1016/j.kint.2023.12.018 |
| Rights: | info:eu-repo/semantics/openAccess |
| رقم الانضمام: | edsbas.E2B2B7F3 |
| قاعدة البيانات: | BASE |
| DOI: | 10.1016/j.kint.2023.12.018 |
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