Archive for the ‘Pregnancy and Hypertension/Renal Disease’ Category

February 9, 2017

Managing glomerular disease in pregnancy

This article reviews the pre-pregnancy counseling that women with glomerular-based diseases should ideally receive to allow them to make an informed decision about proceeding with a pregnancy as well as an approach to the diagnosis of pregnancy-associated worsening of kidney function and proteinuria as well as pregnancy-safe management strategies.

No Comments Posted in Clinical Nephrology, Pregnancy and Hypertension/Renal Disease, Review
May 29, 2016

Pregnancy across the spectrum of chronic kidney disease

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  This paper highlights some of the available data as well as management strategies for nephrologists managing pregnant patients with chronic kidney disease.    

No Comments Posted in Clinical Nephrology, Pregnancy and Hypertension/Renal Disease
September 21, 2015

Risk of Adverse Pregnancy Outcomes in Women with CKD

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With the increasing prevalence of CKD in pregnancy, it is important that both physicians and patients are aware of the risks.  In this Torino-Cagliari Observational Study (TOCOS), 504 pregnancies in women with CKD were compared with 836 low-risk pregnancies in women without CKD.  There were multiple pregnancy outcomes that were studied and divided into “general” […]

No Comments Posted in Chronic Kidney Disease, Pregnancy and Hypertension/Renal Disease
March 18, 2015

Less-Tight versus Tight Control of Hypertension in Pregnancy

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This open, multicentre trial assigned women with nonproteinuric or gestatational hypertension to less tight control (target diastolic BP 100 mmHg) vs tight control (target diastolic BP 85 mmHg) with no difference observed in the primary outcome of pregnancy loss, high level neonatal care or overall maternal complications (secondary outcome).  However, the less tight control group […]

No Comments Posted in Clinical Nephrology, Clinical Trial Results, General Nephrology, Hypertension, Pregnancy and Hypertension/Renal Disease
January 24, 2015

Gestational Hypertension and Preeclampsia in Living Kidney Donors

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This retrospective cohort study of living donors matched to healthy nondonors in Ontario, Canada showed that young women who donated a kidney were more likely to suffer from gestational hypertension or preeclampsia (OR for donors 2.4).  There were no significant differences with respect to preterm birth or low birth weight.

No Comments Posted in Hypertension, Pregnancy and Hypertension/Renal Disease
November 16, 2014

Gestational Hypertension and Preeclampsia in Living Kidney Donors

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This retrospective cohort study showed an increased risk of gestational hypertension or preeclampsia in women who have been living kidney donors, 11% in donors vs 5% in non-donors (OR 2.4; 95% CI, 1.2 to 5.0; P=0.01).

No Comments Posted in Pregnancy and Hypertension/Renal Disease, Renal Transplantation
April 19, 2014

Intensive Hemodialysis Associates with Improved Pregnancy Outcomes: A Canadian and United States Cohort Comparison

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This elegant cohort comparison study shows that pregnant ESRD patients in Canada have better pregnancy-related outcomes (including higher live birth rate and mean gestational age) compared to their American counterparts due to more intensive hemodialysis.

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April 1, 2013

Association between hypertensive disorders during pregnancy and end-stage renal disease: a population-based study

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This study using insurance claims of over 26 000 woman compared to randomly selected controls to assess the risk of chronic kidney disease and end-stage kidney disease in patients with hypertension during pregnancy. The results showed that they had a greater risk of CKD and ESRD with adjusted HRs of with adjusted HRs of 9.38 […]

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November 29, 2011

Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review

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Thirteen observational studies were included in this systematic review of pregnant women with chronic kidney disease (CKD).  Pregnant women on dialysis or with a history of transplantation were excluded.  Adverse maternal outcomes were reported in twelve studies were approximately five times higher in women with CKD.  These include gestational hypertension, preeclampsia and maternal mortality.  Adverse […]

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October 8, 2011

Clinical practice. Chronic hypertension in pregnancy.

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This is an excellent review on the management of pre-existing hypertension in the setting of pregnancy.

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September 27, 2010

Management of hypertensive disorders during pregnancy: summary of NICE guidance

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This is a comprehensive summary of management of hypertension in pregnancy based on the best available evidence where it exists.

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May 1, 2010

Vitamins C and E to Prevent Complications of Pregnancy-Associated Hypertension

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This multicenter, randomized, double-blind trial randomized low risk nulliparous women to daily supplementation with vitamin C and vitamin E or placebo early in pregnancy. The study failed to reduce the primary outcome of severe pregnancy-associated hypertension alone or severe/mild hypertension with elevated liver-enzyme levels, thrombocytopenia, elevated serum creatinine levels, eclamptic seizure, medically indicated preterm birth, […]

1 Comment Posted in Pregnancy and Hypertension/Renal Disease
October 18, 2009

Induction of labour versus expectant monitoring for gestational hypertension or mild pre-eclampsia after 36 weeks’ gestation (HYPITAT): a multicentre, open-label randomised controlled trial

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This multicentre, open-label RCT examined whether induction of labor was superior to expectant management in pregnancies complicated by gestational hypertension or mild pre-eclampsia.

1 Comment Posted in Pregnancy and Hypertension/Renal Disease