medigraphic.com
Federación Mexicana de Ginecología y Obstetricia, A.C.

2021, Number 03

<< Back Next >>

Ginecol Obstet Mex 2021; 89 (03)

Obstetrical and fetal outcomes in patients with chronic kidney disease

Bustillos-Hernández DZ, Arredondo-Maldonado LI

Language: Spanish
References: 20
Page: 185-193
PDF size: 194.53 Kb.


ABSTRACT

Objective: To describe the maternal-fetal outcome of a group of patients with chronic kidney disease.
Materials and Methods: Descriptive, retrospective, cross-sectional study performed in pregnant patients, with chronic kidney disease, attended between 2017 and 2018 at the Hospital General de Zona 4 of IMSS Celaya, Guanajuato, Mexico. Data were obtained from clinical records by non-probabilistic convenience sampling. Descriptive statistics were used for sociodemographic data, Kolmogorov-Smirnov and Shapiro- Wilk tests were used for inferential analysis, and the Wilcoxon test was used for signs.
Results: Fourteen patients with mean age of 28.64 ± 4.72 years were studied, 8 of them with severe renal disease during pregnancy and 9 of the 14 with preeclampsia. One patient had twin pregnancy. The glomerular filtration rate decreased in all stages at the end of pregnancy. Five patients required hemodialysis and two died. Twelve births were recorded, of which 9 were preterm, with mean weight 2111.66 ± 824.71 g; 6 were small for gestational age.
Conclusions: Pregnancy negatively impacts renal function in patients with chronic kidney disease because it increases the risk of preeclampsia, preterm delivery, or low birth weight.


REFERENCES

  1. Ibarra-Hernández M, Jiménez-Alvarado P, Albarrán-López P, Botello-Ramírez SA. Enfermedad renal crónica durante el embarazo. Revista Médica MD 2015; 5 (3):119-25. https://www.medigraphic.com/cgi-bin/new/resumen. cgi?IDARTICULO=55600.

  2. Guzmán-Solís M, Sánchez-Rodríguez O, Montaño-Martínez A, Peredo-Villa DE, Paniagua-Sierra R, et al. Desenlaces obstétricos en mujeres embarazadas con enfermedad renal crónica y factores asociados. Ginecol Obstet Mex 2020; 88 (4):230-43. https://doi.org/10.24245/gom. v88i4.3325.

  3. Tangren J. Nadel M, Hladunewich MA. Pregnancy and endstage renal disease. Blood Purif 2018; 45: 194-200. http:// doi.org/10.1159/000485157.

  4. Palmer B. Clegg D. Gonadal dysfunction in chronic kidney disease. Rev Endocr Metab Disord 2017;18(1): 117-130. https://doi.org/10.1007/s11154-016-9385-9.

  5. Kidney disease improving global outcomes 2012. Clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney international supplements 2013; 3 (1) 5-14. Disponible en https://kdigo.org/guidelines/ ckd-evaluation-and-management/

  6. Hui D, Hladunewich M. Chronic kidney disease and pregnancy. Obstet Gynecol 2019; 133:1182–94. doi. 10.1097/ AOG.0000000000003256 .

  7. Wiles K, Chappell L, Clark K, Elman L. Clinical practice guideline on pregnancy and renal disease. BMC Nephrology 2019 20:401 . https://doi.org/10.1186/s12882-019-1560-2

  8. Rojas W, Cantillo JJ, Cantillo MJ. Enfermedad renal crónica y embarazo, un desafío en la atención clínica y desenlace obstétrico. Acta Med Colomb 2015; 40: 331-37. https:// www.redalyc.org/articulo.oa?id=163143293009

  9. Polanco-Nasser A. Posibilidad de llevar a término el embarazo en pacientes con enfermedad renal crónica. Ginecol Obstet Mex 2015; 83 (12): 807-17. https://www.medigraphic. com/cgi-bin/new/resumen.cgi?IDARTICULO=62040

  10. Hladunewich MA, Melamed N, Bramham K, et al. Pregnancy across the spectrum of chronic kidney disease. Kidney International 2016; 89: 995-1007. http://dx.doi. org/10.1016/j.kint.2015.12.050

  11. He Y, Liu J, Cai Q, Lv J, et al. The pregnancy outcomes in patients with stage 3-4 chronic kidney disease and the effects of pregnancy in the long-term kidney function. Journal of nephrology 2018; 31: 953-960. https://doi.org/10.1007/ s40620-018-0509-z.

  12. Kendrick J, Sharma S, Holmen J, Kidney disease and maternal and fetal outcomes in pregnancy 2015; 66 (1): 55-59. https://doi.org/10.1053/j.ajkd.2014.11.019

  13. Davidson N, Wolski P, Callaway LK, Barrett HL, Palit S, et al. Chronic kidney disease in pregnancy: maternal and fetal outcomes a progression of kidney disease. Obstetric Medicine 2015; 8 (2): 92-98. doi. 10.1177/1753495X15576461

  14. Detección, diagnóstico y tratamiento de enfermedades hipertensivas del embarazo. Guía de evidencias y recomendaciones. Guía de práctica clínica. México, IMSS:2017. Disponible en http://cenetec-difusion.com/gpc-sns/?s=en fermedades+hipertensivas+del+embarazo

  15. Turbay Y, Carballo V. Hipertensión en el embarazo. Acta Médica Colombiana 2019; 44 (2): 71-75. ISSN 2248-6054. https://go.gale.com/ps/anonymous?id=GALE%7CA6035 03502&sid=googleScholar&v=2.1&it=r&linkaccess=abs&i ssn = 01202448&p=AONE&sw=w

  16. Herrera K. Preeclampsia. Revista Médica Sinergia 2013; 3 (3): 8-12. ISSN 2215-4523 EISSN 2215-5279. https://revistamedicasinergia. com/index.php/rms/article/view/117

  17. Arriola-López AA. Caracterización del recién nacido pequeño para la edad gestacional. Acta pediátrica Hondureña 2017; 8 (2): 769-75. https://doi.org/10.5377/pediatrica. v8i2.7978

  18. Sociedad Argentina de Pediatría. Restricción del crecimiento intrauterino: perspectiva endocrinológica. Arch Argent Pediatr 2017; 115 (3): s63-s67. http://dx.doi.org/10.5546/ aap.2017.s63

  19. Arce VR, Vázquez SR, Gutiérre MT. Actualización en el manejo de labor de parto pretérmino. Revista Médica Sinergia 2020; 5 (1): e330. https://doi.org/10.31434/rms.v5i1.330.

  20. García A, Jimenez-Baez MV, González-Ortiz DG, De la Cruz- Toledo P, et al. Características clínicas, epidemiológicas y riesgo obstétrico de pacientes con preeclampsia eclampsia. Rev Enferm Inst Mex Seguro Soc. 2018; 26 (4): 256-62.




2020     |     www.medigraphic.com