Preeclampsia and Long-term Renal Function in Women Who Underwent Kidney Transplantation.

Détails

ID Serval
serval:BIB_4C4F1CB243A4
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Preeclampsia and Long-term Renal Function in Women Who Underwent Kidney Transplantation.
Périodique
Obstetrics and gynecology
Auteur(s)
Vannevel V., Claes K., Baud D., Vial Y., Golshayan D., Yoon E.W., Hodges R., Le Nepveu A., Kerr P.G., Kennedy C., Higgins M., Resch E., Klaritsch P., Van Mieghem T.
ISSN
1873-233X (Electronic)
ISSN-L
0029-7844
Statut éditorial
Publié
Date de publication
01/2018
Peer-reviewed
Oui
Volume
131
Numéro
1
Pages
57-62
Langue
anglais
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Résumé
Preeclampsia often complicates pregnancies after maternal kidney transplantation. We aimed to assess whether preeclampsia is associated with kidney function decline either during the pregnancy or in the long term.
We performed an international multicenter retrospective cohort study. Renal function at conception, pregnancy outcomes, and short- and long-term graft outcomes were collected for women who were pregnant after renal transplantation and had transplant and obstetric care at the participating centers. In women who had multiple pregnancies during the study period, only the last pregnancy was included. Univariate and multivariable analyses were performed.
We retrieved pregnancy outcomes and long-term renal outcomes for 52 women. Chronic hypertension was present at baseline in 27%. Mean estimated glomerular filtration rate (GFR) at start of pregnancy was 52.4±17.5 mL/min/1.73 m. Mean estimated GFR at delivery was 47.6±21.6 mL/min/1.73 m, which was significantly lower than at conception (P=.03). Twenty women (38%) developed preeclampsia. In multivariable analysis, women who developed preeclampsia had a 10.7-mL/min/1.73 m higher drop in estimated GFR between conception and delivery than women who did not develop preeclampsia (P=.02). Long-term estimated GFR follow-up was obtained at a median of 5.8 years (range 1.3-27.5 years). Mean estimated GFR at last follow-up was 38±23 mL/kg/1.73 m. Seventeen women (33%) experienced graft loss over the follow-up period. Incidence of graft loss was similar in women with and without preeclampsia in their last pregnancy (30% and 34%, respectively; P=.99). In multivariable analysis, the decrease in estimated GFR between conception and last follow-up was similar in women who experienced preeclampsia during pregnancy and those who did not (difference -2.69 mL/min/1.73 m, P=.65).
Preeclampsia commonly complicates pregnancies after renal transplantation but is not associated with long-term renal dysfunction or graft loss.

Mots-clé
Adult, Analysis of Variance, Cohort Studies, Confidence Intervals, Disease Progression, Female, Glomerular Filtration Rate/physiology, Graft Rejection, Humans, Hypertension/physiopathology, Internationality, Kidney Function Tests, Kidney Transplantation/adverse effects, Kidney Transplantation/methods, Linear Models, Multivariate Analysis, Pre-Eclampsia/etiology, Pre-Eclampsia/physiopathology, Pregnancy, Pregnancy Outcome, Retrospective Studies, Risk Assessment, Time Factors
Pubmed
Web of science
Création de la notice
08/12/2017 10:36
Dernière modification de la notice
20/08/2019 14:00
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