Am J Perinatol 2008; 25(7): 399-405
DOI: 10.1055/s-0028-1083838
© Thieme Medical Publishers

Pregnancy in Women with Renal Disease. Part II: Specific Underlying Renal Conditions

Alex C. Vidaeff1 , Edward R. Yeomans1 , Susan M. Ramin1
  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Medical School at Houston, Houston, Texas
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
21. August 2008 (online)

ABSTRACT

The obstetric outcome in women with kidney disease has improved in recent years due to continuous progress in obstetrics and neonatology, as well as better medical management of hypertension and renal disease. However, every pregnancy in these women remains a high-risk pregnancy. When considering the interaction between renal disease and pregnancy, maternal outcomes are related to the initial level of renal dysfunction more than to the specific underlying disease. With regards to fetal outcomes, though, a distinction may exist between renal dysfunction resulting from primary renal disease and that in which renal involvement is part of a systemic disease. In part II of this review, some specific causes of renal failure affecting pregnancy are considered.

REFERENCES

  • 1 Rossing K, Jacobsen P, Hommel E et al.. Pregnancy and progression of diabetic nephropathy.  Diabetologia. 2002;  45 36-41
  • 2 Reece E A, Leguizamon G, Homko C. Pregnancy performance and outcomes associated with diabetic nephropathy.  Am J Perinatol. 1998;  15 413-421
  • 3 Kimmerle R, Zass R-P, Cupisti S et al.. Pregnancies in women with diabetic nephropathy: long-term outcome for mother and child.  Diabetologia. 1995;  38 227-235
  • 4 Parving H H, Andersen A R, Smidt U M, Hommel E, Mathiesen E R, Svendsen P A. Effect of antihypertensive treatment on kidney function in diabetic nephropathy.  Br Med J (Clin Res Ed). 1987;  294 1443-1447
  • 5 Khandelwal M, Kumanova M, Gaughan J P, Reece E A. Role of diltiazem in pregnant women with chronic renal disease.  J Matern Fetal Neonatal Med. 2002;  12 408-412
  • 6 Purdy L P, Hantsch C E, Molitch M E et al.. Effect of pregnancy on renal function in women with moderate to severe diabetic renal insufficiency.  Diabetes Care. 1996;  19 1067-1074
  • 7 Reece E A, Coustan D R, Hayslett J P et al.. Diabetic nephropathy: pregnancy performance and fetomaternal outcome.  Am J Obstet Gynecol. 1988;  159 56-66
  • 8 White P. Pregnancy complicating diabetes.  Am J Med. 1949;  7 609-616
  • 9 Gordon M, Landon M B, Samuels P, Hissrich S, Gabbe S G. Perinatal outcome and long-term follow-up associated with modern management of diabetic nephropathy.  Obstet Gynecol. 1996;  87 401-409
  • 10 Biesenbach G, Zazgornik J. Incidence of transient nephrotic syndrome during pregnancy in diabetic women with and without pre-existing microalbuminuria.  BMJ. 1989;  299 366-367
  • 11 Kitzmiller J L, Combs C A. Diabetic nephropathy and pregnancy.  Obstet Gynecol Clin North Am. 1996;  23 173-203
  • 12 Esdaile J M, Levinton C, Federgreen W, Hayslett J P, Kashgarian M. The clinical and renal biopsy predictors of long-term outcome in lupus nephritis: a study of 87 patients and review of literature.  Q J Med. 1989;  72 779-833
  • 13 Harrower A D. Pharmacokinetics of oral antihyperglycaemic agents in patients with renal insufficiency.  Clin Pharmacokinet. 1996;  31 111-119
  • 14 Jones D C. Pregnancy complicated by chronic renal disease.  Clin Perinatol. 1997;  24 483-496
  • 15 Khamashta M A, Hughes G R. Pregnancy in systemic lupus erythematosus.  Curr Opin Rheumatol. 1996;  8 424-429
  • 16 Julkunen H, Kaaya R, Palosuo T, Grbnhagen-Riska C, Teramo K. Pregnancy in lupus nephropathy.  Acta Obstet Gynecol Scand. 1993;  72 258-263
  • 17 Huong D L, Wechsler B, Vauthier-Brouzes D. Pregnancy in past or present lupus nephritis: a study of 32 pregnancies from a single centre.  Ann Rheum Dis. 2001;  60 599-604
  • 18 Fine L G, Barnett E V, Danovitch G M et al.. Systemic lupus erythematosus in pregnancy.  Ann Intern Med. 1981;  94 667-677
  • 19 Ostensen M. Sex hormones and pregnancy in rheumatoid arthritis and systemic lupus erythematosus.  Ann N Y Acad Sci. 1999;  876 131-143
  • 20 Lubbe W F, Butler W S, Palmer S J, Liggins G C. Lupus anticoagulant in pregnancy.  Br J Obstet Gynaecol. 1984;  91 357-363
  • 21 Moroni G, Quaglini S, Banfi G et al.. Pregnancy in lupus nephritis.  Am J Kidney Dis. 2002;  40 713-720
  • 22 Rai R, Cohen H, Dave M, Regan L. Randomized controlled trial of aspirin and aspirin plus heparin in pregnant women with recurrent miscarriage associated with phospholipids antibodies (or antiphospholipid antibodies).  BMJ. 1997;  314 253-257
  • 23 Tomer Y, Viegas O AC, Swissa M, Koh S CL, Shoenfeld Y. Levels of lupus autoantibodies in pregnant SLE patients: correlations with disease activity and pregnancy outcome.  Clin Exp Rheumatol. 1996;  14 275-280
  • 24 Wong K L, Chan F Y, Lee C P. Outcome of pregnancy in patients with systemic lupus erythematosus: a prospective study.  Arch Intern Med. 1991;  151 269-273
  • 25 Hayslett J P, Lynn R I. Effect of pregnancy in patients with lupus nephropathy.  Kidney Int. 1980;  18 207-220
  • 26 Imbasciati E, Surian M, Bottino S et al.. Lupus nephropathy and pregnancy.  Nephron. 1984;  36 46-51
  • 27 Bobrie G, Liote F, Houillier P, Grünfeld J P, Jungers P. Pregnancy in lupus nephritis and related disorders.  Am J Kidney Dis. 1987;  9 339-343
  • 28 Golbus J, McCune W J. Lupus nephritis. Classification, prognosis, immunopathogenesis and treatment.  Rheum Dis Clin North Am. 1994;  20 213-242
  • 29 Fox D A, McCune W J. Immunosuppressive drug therapy of systemic lupus erythematosus.  Rheum Dis Clin North Am. 1994;  20 265-299
  • 30 Dinant H J, Decker J L, Klippel J H, Balow J E, Plotz P H, Steinberg A D. Alternative modes of cyclophosphamide and azathioprine therapy in lupus nephritis.  Ann Intern Med. 1982;  96 728-736
  • 31 Petri M. Pregnancy in SLE.  Baillieres Clin Rheumatol. 1998;  12 449-476
  • 32 Kirshon B, Wasserstrum N, Willis R, Herman G E, McCabe E R. Teratogenic effects of first-trimester cyclophosphamide therapy.  Obstet Gynecol. 1988;  72 462-464
  • 33 McGrory C H, McCloskey L J, DeHoratius R J, Dunn S R, Moritz M J, Armenti V T. Pregnancy outcomes in female renal recipients: a comparison of systemic lupus erythematosus with other diagnoses.  Am J Transplant. 2003;  3 35-42
  • 34 Wilczek H E, Jaremko G, Tyden G, Groth C G. Evolution of diabetic nephropathy in kidney grafts.  Transplantation. 1995;  59 51-57
  • 35 Jungers P, Chauveau D. Pregnancy in renal disease.  Kidney Int. 1997;  52 871-885
  • 36 Katzir Z, Rotmensch S, Boaz M, Biro A, Michlin A, Smetana S. Pregnancy in membranous glomerulonephritis: course, treatment and outcome.  Clin Nephrol. 2004;  61 59-62
  • 37 Packham D K, North R A, Fairley K F, Whitworth J A, Kincaid-Smith P. Membranous glomerulonephritis and pregnancy.  Clin Nephrol. 1987;  28 56-64
  • 38 Barcelo P, Lopez-Lilo J, Cabero L, Del Rio G. Successful pregnancy in primary glomerular disease.  Kidney Int. 1986;  30 914-919
  • 39 Jungers P, Houillier P, Forget D, Henry-Amar M. Specific controversies concerning the natural history of renal disease in pregnancy.  Am J Kidney Dis. 1991;  17 116-122
  • 40 Jungers P, Houillier P, Forget D et al.. Influence of pregnancy on the course of primary chronic glomerulonephritis.  Lancet. 1995;  346 1122-1124
  • 41 Packham D K, North R A, Fairley K F, Whitworth J A, Kincaid-Smith P. IgA glomerulonephritis and pregnancy.  Clin Nephrol. 1988;  30 15-21
  • 42 Hemmelder M H, de Zeeuw D, Fidler V, de Jong P E. Proteinuria: a risk factor for pregnancy-related renal function decline in primary glomerular disease?.  Am J Kidney Dis. 1995;  26 187-192
  • 43 Armenti V T, Moritz M J, Davison J M. Drug safety issues in pregnancy following transplantation and immunosuppression: effects and outcomes.  Drug Saf. 1998;  19 219-232
  • 44 Mansfield J T, Snow B W, Cartwright P C, Wadsworth K. Complications of pregnancy in women after childhood reimplantations for vesicoureteral reflux: an update with 25 years of followup.  J Urol. 1995;  154 787-790
  • 45 Jungers P, Houillier P, Chauveau D et al.. Pregnancy in women with reflux nephropathy.  Kidney Int. 1996;  50 593-599
  • 46 Jungers P, Chauveau D, Choukroun G et al.. Pregnancy in women with impaired renal function.  Clin Nephrol. 1997;  47 281-288
  • 47 Austenfeld M S, Snow B W. Complications of pregnancy in women after reimplantation for vesicoureteral reflux.  J Urol. 1988;  140 1103-1106
  • 48 Cunningham F G, Cox S M, Harstad T W, Mason R A, Pritchard J A. Chronic renal disease and pregnancy outcome.  Am J Obstet Gynecol. 1990;  163 453-459
  • 49 Noe H N. The current status of screening for vesicoureteral reflux.  Pediatr Nephrol. 1995;  9 638-641
  • 50 Willis F R, Findlay C A, Gorrie M J, Watson M A, Wilkinson A G, Beatties T J. Children of renal transplant recipient mothers.  J Paediatr Child Health. 2000;  36 230-235
  • 51 Perrone R D. Extrarenal manifestations of ADPKD.  Kidney Int. 1997;  51 2022-2036
  • 52 Choukroun G, Itakura Y, Allbouze G et al.. Factors influencing progression of renal failure in autosomal dominant polycystic kidney disease.  J Am Soc Nephrol. 1995;  6 1634-1642
  • 53 Chapman A B. Cystic disease in women: clinical characteristics and medical management.  Adv Ren Replace Ther. 2003;  10 24-30
  • 54 Chapman A B, Johnson A M, Gabow P A. Pregnancy outcome and its relationship to progression of renal failure in autosomal dominant polycystic kidney disease.  J Am Soc Nephrol. 1994;  5 1178-1185
  • 55 Gibbs G F, Huston III J, Qian Q et al.. Follow-up of intracranial aneurysms in autosomal-dominant polycystic kidney disease.  Kidney Int. 2004;  65 1621-1627
  • 56 Mariani L, Bianchetti M G, Schroth G, Seiler R W. Cerebral aneurysms in patients with autosomal dominant polycystic kidney disease—to screen, to clip, to coil?.  Nephrol Dial Transplant. 1999;  14 2319-2322
  • 57 Rubin S M, Jackson G M, Cohen A W. Management of the pregnant patient with a cerebral venous angioma: a report of two cases.  Obstet Gynecol. 1991;  78 929-931
  • 58 Parikh C R, McCall D, Engelman C, Schrier R W. Congenital renal agenesis: case-control analysis of birth characteristics.  Am J Kidney Dis. 2002;  39 689-694
  • 59 Zondek T, Zondek L H. Unilateral renal agenesis in the female with special references to associated malformations in the genital tract.  J Obstet Gynaecol. 1989;  10 113-116
  • 60 Heinonen P K. Gestational hypertension and preeclampsia associated with unilateral renal agenesis in women with uterine malformations.  Eur J Obstet Gynecol Reprod Biol. 2004;  114 39-43
  • 61 Rugiu C, Oldrizzi L, Lupo A et al.. Clinical features of patients with solitary kidneys.  Nephron. 1986;  43 10-15
  • 62 Buszta C, Steinmuller D R, Novick A C et al.. Pregnancy after donor nephrectomy.  Transplantation. 1985;  40 651-654
  • 63 Davison J M. Changes in renal function in early pregnancy in women with one kidney.  Yale J Biol Med. 1978;  51 347-349
  • 64 Chervenak F A, McCullough L B, Chasen S T. Ethics: an essential dimension of first-trimester risk assessment for trisomy 21.  Female Patient. 2005;  30 21-24
  • 65 Oniscu G C, Brown H, Forsythe J LR. Impact of cadaveric renal transplantation on survival in patients listed for transplantation.  J Am Soc Nephrol. 2005;  16 1859-1865

Alex C VidaeffM.D. 

Department of Obstetrics, Gynecology, and Reproductive Sciences, The University of Texas Medical School at Houston

6431 Fannin, Suite 3.604, Houston, TX 77030

eMail: alex.c.vidaeff@uth.tmc.edu

    >