Impact of Pregnancy on GFR Decline and Kidney Histology in Kidney Transplant Recipients.
Impact of Pregnancy on GFR Decline and Kidney Histology in Kidney Transplant Recipients.
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DOI：
10.1016/j.ekir.2021.10.010
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发表时间：
2022-01
影响因子：
6
通讯作者：
Garovic VD
中科院分区：
文献类型：
--
作者：
Kattah AG;Albadri S;Alexander MP;Smith B;Parashuram S;Mai ML;Khamash HA;Cosio FG;Garovic VD
建议晚期肾病女性等到移植后再怀孕，但妊娠对估计肾小球滤过率（eGFR）下降和肾脏组织学的影响尚不清楚。我们在1996年至2014年在我们的3个中心项目中确定了一组年龄在18至44岁之间的女性移植患者（N = 816），并通过图表审查确定她们是否在移植后妊娠>20周。结果包括妊娠后eGFR的变化率、妊娠前后肾组织学的变化、移植失败和eGFR降低50%。有37名妇女在移植后有一次或多次妊娠持续时间超过20周。比较移植后妊娠和未妊娠的女性，妊娠后eGFR下降率显著增加（-2.4 ml/min/1.73 m2/年vs.-1.9 ml/min/1.73 m2/年，未妊娠的女性，P < 0.001）。妊娠不影响移植失败、死亡删失移植失败或eGFR降低50%的风险。妊娠影响移植物中eGFR下降的速率。妊娠后活检结果显示血管损伤增加，这可能是一个潜在的机制。我们没有发现由于妊娠导致移植失败的风险显著增加或eGFR降低50%。
Women with advanced kidney disease are advised to wait until after transplant to pursue pregnancy, but the impact of pregnancy on estimated glomerular filtration rate (eGFR) decline and kidney histology is unclear. We identified a cohort of women aged 18 to 44 years at transplant from 1996 to 2014 at our 3-site program (N = 816) and determined whether they had a pregnancy >20 weeks gestation post-transplant by chart review. Outcomes included rate of change in eGFR after pregnancy, changes in kidney histology before and after pregnancy, graft failure, and 50% reduction in eGFR. There were 37 women with one or more pregnancies lasting longer than 20 weeks gestation post-transplant. Comparing women with and without pregnancy post-transplant, there was a significant increase in the rate of eGFR decline after pregnancy (−2.4 ml/min per 1.73 m2 per year vs. −1.9 ml/min per 1.73 m2 per year in women with no pregnancy, P < 0.001). Pregnancy did not affect the risk of graft failure, death-censored graft failure, or 50% reduction in eGFR. Pregnancy affects the rate of eGFR decline in the allograft. Postpregnancy biopsy findings revealed an increase in vascular injury, which could be a potential mechanism. We did not find a significant increase in risk of graft failure or reduction in eGFR by 50% owing to pregnancy.
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DOI：
10.2215/cjn.00470112
发表时间：
2012-12-01
影响因子：
9.8
作者：
Odutayo, Ayodele;Hladunewich, Michelle
通讯作者：
Hladunewich, Michelle
影响因子：
7.2
作者：
Vannevel, Valerie;Claes, Kathleen;Van Mieghem, Tim
通讯作者：
Van Mieghem, Tim
他克莫司在怀孕期间的药代动力学。
影响因子：
2.5
作者：
Zheng S;Easterling TR;Umans JG;Miodovnik M;Calamia JC;Thummel KE;Shen DD;Davis CL;Hebert MF
通讯作者：
Hebert MF
影响因子：
8.8
作者：
Rose, C.;Gill, J.;Gill, J. S.
通讯作者：
Gill, J. S.
影响因子：
0.9
作者：
Kolonko, A.;Chudek, J.;Wiecek, A.
通讯作者：
Wiecek, A.