Abstract：
OBJECTIVE:Chronic kidney disease (CKD) pregnancies are at high risk of developing adverse outcomes. In non-pregnant subjects with CKD, higher urinary IgM levels are associated with poor renal survival and higher rates of cardiovascular deaths. In this study, we assessed whether urinary IgM levels are associated with an increased risk of adverse pregnancy outcomes (APO) in CKD pregnancies. METHODS:We performed a nested case-control study within a cohort of CKD patients with singleton pregnancies attended at a tertiary care hospital. The study included 90 CKD patients who eventually developed one or more APO and 77 CKD patients who did not. Urinary IgM excretion was determined from the 24-h urine samples at enrollment by an ultrasensitive enzyme immunoassay. RESULTS:The risk for combined APO and for preeclampsia (PE) was higher among women with urinary IgM and proteinuria levels values in the highest quartile or with CKD stages 4-5 (odds ratios, OR ≥ 2.9), compared with the lowest quartile or with CKD stage 1. Urinary IgM levels were more closely associated with the risk of either combined or specific APO (PE, preterm birth, and for having a small-for-gestational-age infant; OR ≥ 5.9) than either the degree of total proteinuria or CKD stages. Among patients with CKD stage 1, the risk of combined APO, PE, and preterm birth was higher in women with urinary IgM levels values in the highest quartile (OR ≥ 4.8), compared with the three lower quartiles, independently of proteinuria. CONCLUSION:In CKD pregnancies, at the time of initial evaluation, proteinuria and CKD stage are associated with increased risk of combined APO. However, urinary IgM concentrations appear to be better predictors of an adverse outcome and may be useful for risk stratification in CKD pregnancies.
journal_name
J Nephroljournal_title
Journal of nephrologyauthors
Leaños-Miranda A,Campos-Galicia I,Ramírez-Valenzuela KL,Berumen-Lechuga MG,Isordia-Salas I,Molina-Pérez CJdoi
10.1007/s40620-018-0536-9subject
Has Abstractpub_date
2019-04-01 00:00:00pages
241-251issue
2eissn
1121-8428issn
1724-6059pii
10.1007/s40620-018-0536-9journal_volume
32pub_type
杂志文章abstract：:The management of rapidly progressive glomerulonephritis has been transformed over the past thirty years. It has become one of the few forms of glomerulonephritis that can be effectively treated, and today overall renal survival is as high as 70%. Effective management of patients with RPGN requires prompt and accurate...
journal_title：Journal of nephrology
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更新日期：1999-07-01 00:00:00
abstract：BACKGROUND:Reset osmostat (RO) occurs in 36% of patients with syndrome of inappropriate antidiuretic hormone secretion (SIADH) and is not often considered when evaluating hyponatremic patients. Patients with RO are not usually treated, but recent awareness that symptoms are associated with mild hyponatremia creates a t...
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abstract：BACKGROUND:Functional failure of the peritoneal membrane is the most serious problem in long-term continuous ambulatory peritoneal dialysis (CAPD). Transforming growth factor-beta (TGF-ss) is one of the key mediators of fibrosis in some organs, and is thought to be involved in peritoneal alterations. In this study, we ...
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abstract：:Icodextrin, a glucose polymer, is widely used as an alternative to glucose as the osmotic agent in peritoneal dialysis (PD). We describe a case of a continuous ambulatory peritoneal dialysis patient who developed severe cutaneous hypersensitivity after initiation of icodextrin PD solution. Erythematous skin lesions gr...
journal_title：Journal of nephrology
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abstract：:Influenza is a commonly encountered and serious pathogen. Patients with end-stage renal disease are more susceptible to serious morbidity and mortality associated with influenza infection. Proper management of patients includes: vaccination, monitoring for symptoms and isolation of potentially infected patients as wel...
journal_title：Journal of nephrology
pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0407-9
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journal_title：Journal of nephrology
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journal_title：Journal of nephrology
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doi：10.1007/s40620-016-0324-3
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pub_type： 杂志文章,评审
doi：10.1007/s40620-017-0404-z
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pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：2008-03-01 00:00:00
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pub_type： 杂志文章
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pub_type： 杂志文章,评审
doi：
更新日期：2001-11-01 00:00:00
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
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journal_title：Journal of nephrology
pub_type： 杂志文章,评审
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pub_type： 杂志文章,多中心研究
doi：10.1007/s40620-015-0186-0
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journal_title：Journal of nephrology
pub_type： 杂志文章,随机对照试验
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journal_title：Journal of nephrology
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更新日期：1998-01-01 00:00:00
