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学科主题: 临床医学
题名:
Risk Factors for Pregnancy Outcomes in Patients With IgA Nephropathy: A Matched Cohort Study
作者: Liu, Youxia1; Ma, Xinxin1; Lv, Jicheng1; Shi, Sufang1; Liu, Lijun1; Chen, Yuqing1; Zhang, Hong1
关键词: Immunoglobulin A nephropathy (IgAN) ; pregnancy ; chronic kidney disease (CKD) ; kidney disease progression ; renal function ; pregnancy outcomes
刊名: AMERICAN JOURNAL OF KIDNEY DISEASES
发表日期: 2014-11-01
DOI: 10.1053/j.ajkd.2014.06.021
卷: 64, 期:5, 页:730-736
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Urology & Nephrology
研究领域[WOS]: Urology & Nephrology
关键词[WOS]: GLOMERULAR-DISEASES ; CHINESE POPULATION ; GLOMERULONEPHRITIS ; PROGNOSIS
英文摘要:

Background: The outcomes of pregnancy in immunoglobulin A nephropathy (IgAN) are uncertain. This study assessed the effects of pregnancy on kidney disease progression and risk factors for adverse pregnancy outcomes in IgAN.

Study Design: A matched-cohort study.

Setting & Participants: Women with IgAN with at least one pregnancy, 1 year of follow-up, and kidney function and proteinuria measurement at baseline (time of biopsy) matched with nonpregnant women with IgAN from Peking University First Hospital.

Predictors: Pregnancy, treated as a time-dependent variable; proteinuria; hypertension; and estimated glomerular filtration rate (eGFR).

Outcomes: Kidney disease progression, defined as eGFR halving or end-stage kidney disease; rate of eGFR decline; and adverse pregnancy outcomes, including severe pre-eclampsia, intrauterine death, embryo damage, fetal malformation, and induced and spontaneous abortions.

Results: Of 239 female patients, 62 women had 69 pregnancies and 62 matched nonpregnant patients were selected as controls. Pregnant patients had median proteinuria at baseline with protein excretion of 1.27 (range, 0.06-7.25) g/d and mean eGFR of 102.3 (range, 40.0-139.0) mL/min/1.73m(2). During a mean follow-up of 45.7 months, 4 patients in the pregnancy group and 6 in the nonpregnancy group had kidney disease progression events. Time-dependent Cox analysis showed that pregnancy was not an independent risk factor for kidney disease progression events (HR, 1.2; 95% CI, 0.3-5.7). There was no significant difference in the median rate of eGFR decline in the 2 groups (-2.5 vs -2.4 mL/min/1.73m(2) per year; P = 0.7). Adverse pregnancy outcomes were observed in 15 patients. Proteinuria during pregnancy (OR, 1.39; 95% CI, 0.96-2.01) was a borderline predictor of adverse pregnancy outcomes.

Limitations: Retrospective study, most patients had preserved kidney function, study underpowered to detect a difference in kidney failure events.

Conclusions: The study does not permit a definitive conclusion about the effect of pregnancy on kidney disease progression in IgAN. (C) 2014 by the National Kidney Foundation, Inc.

语种: 英语
所属项目编号: 81270795 ; 81322009 ; NCET-12-0011 ; Z12110700100000 ; 2011-4021-06 ; Z121107001012137 ; 7131016 ; 81021004
项目资助者: National Natural Science Foundation of China ; Program for New Century Excellent Talents in University from the Ministry of Education of China ; Capital Clinical Research ; Beijing Science and Technology Plan ; Beijing Natural Science Foundation ; Natural Science Fund of China
WOS记录号: WOS:000344237900013
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/51679
Appears in Collections:北京大学第一临床医学院_肾脏内科_期刊论文

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作者单位: 1.Peking Univ, Div Renal, Hosp 1, Beijing 100871, Peoples R China
2.Peking Univ, Inst Nephrol, Beijing 100871, Peoples R China
3.Minist Hlth China, Key Lab Renal Dis, Beijing, Peoples R China
4.Peking Univ, Minist Educ, Key Lab Chron Kidney Dis Prevent & Treatment, Beijing 100871, Peoples R China

Recommended Citation:
Liu, Youxia,Ma, Xinxin,Lv, Jicheng,et al. Risk Factors for Pregnancy Outcomes in Patients With IgA Nephropathy: A Matched Cohort Study[J]. AMERICAN JOURNAL OF KIDNEY DISEASES,2014,64(5):730-736.
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