Understanding the link between kidney health and pregnancy outcomes

了解肾脏健康与妊娠结局之间的联系

• 批准号: MR/Y011139/1
• 负责人: Kate Birnie
• 金额: $ 146.27万
• 依托单位: University of Bristol
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY011139%2F1
• 关键词: Understanding; link; between; kidney; health

Reproductive health is important to a woman's overall health and well-being and is increasingly recognised as a sex specific marker for diseases in later life. Women who experience complications of pregnancy, such as pre-eclampsia, are more likely to have heart disease in later life for example. However, there are gaps in our knowledge about whether women who experience complications of pregnancy are more likely to experience reduced kidney function and kidney disease in later life. I will use information from several studies, including large datasets of routinely collected clinical data and smaller studies with detailed measurements, to examine if women who experience different complications in pregnancy are at greater risk of reduced kidney function and kidney disease in later life. Understanding the relationship between women's reproductive health and later disease is important as it may identify the need for increased monitoring of kidney function after pregnancy, crucially as some of the causes of kidney disease are preventable. Women at high risk can then be offered advice or treatment that will lower that risk.There are also gaps in knowledge about whether women who have reduced kidney function prior to pregnancy are at greater risk of developing pregnancy complications. Here, I will measure kidney function prior to pregnancy, in early pregnancy, and throughout pregnancy, to examine if women with reduced kidney function are at greater risk of pregnancy complications such as pre-eclampsia and diabetes in pregnancy. This is important as women are increasingly having children at older ages, and it is vital that we understand what affects women's chances of having a healthy pregnancy. Finally, if kidney function needs to be tested in pregnancy, a substance in the blood called creatinine is measured. However, there is no clear guidance on acceptable levels in pregnancy. I will use multiple studies to address this knowledge gap and with the aim of establishing the normal/acceptable range. I will also examine an alternative measures of kidney function, cystatin C. Unlike creatinine, cystatin C is produced from all cells in the body, rather than just muscles, and so isn't affected by things like muscle mass. The work will provide insights into how women should be managed if changes in creatinine are observed during pregnancy.

生殖健康对女性的整体健康和幸福很重要，越来越多地被认为是晚年疾病的性别标志。例如，经历过妊娠并发症(如先兆子痫)的女性更有可能在晚年患心脏病。然而，对于经历过妊娠并发症的女性是否更有可能在以后的生活中经历肾功能减退和肾脏疾病，我们的认识存在空白。我将使用几项研究的信息，包括常规收集的临床数据的大型数据集，以及带有详细测量的较小研究，以检查在怀孕期间经历不同并发症的女性在以后的生活中是否有更大的风险患上肾功能减退和肾脏疾病。了解妇女生殖健康和后来的疾病之间的关系很重要，因为这可能确定有必要加强对怀孕后肾功能的监测，关键是因为肾脏疾病的一些原因是可以预防的。然后，可以向高危妇女提供建议或治疗，以降低这种风险。对于怀孕前肾功能下降的妇女是否有更大的怀孕并发症风险，也存在知识空白。在这里，我将在怀孕前、怀孕早期和整个怀孕期间测量肾功能，以检查肾功能低下的妇女是否有更高的妊娠并发症风险，如先兆子痫和妊娠期糖尿病。这一点很重要，因为越来越多的女性在高龄生育，我们必须了解是什么影响了女性健康怀孕的机会。最后，如果怀孕期间需要测试肾功能，就需要测量血液中一种名为肌酐的物质。然而，对于怀孕期间的可接受水平，没有明确的指导。我将使用多项研究来解决这一知识差距，目的是建立正常/可接受的范围。我还将研究另一种衡量肾功能的指标--胱抑素C。与肌酸不同，胱抑素C是由体内所有细胞产生的，而不仅仅是肌肉，因此不受肌肉质量等因素的影响。如果观察到怀孕期间肌酐的变化，这项工作将为女性应该如何管理提供洞察力。