Chronic kidney disease in pregnant women
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Chronic kidney disease
pregnant women
glomerular filtration rate

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Pérez Calvo C, Rico Fontalvo J, Lavalle López O, Daza Arnedo R, Pájaro Galvis N, Monterrosa Robles M, Pérez Olivo J, Leal Martínez V, Abuabara Franco E, Benavides Arenas R, Cardona Blanco M, Uparella Gulfo I, Vengoechea Visbal M. Chronic kidney disease in pregnant women: Enfermedad renal crónica en mujeres embarazadas. Rev. Colomb. Nefrol. [Internet]. 2020 Nov. 11 [cited 2024 Jul. 16];8(1):e518. Available from:


Chronic Kidney Disease, defined as a renal structural or functional alteration that persists for more than 3 months, with or without deterioration of renal function, or a glomerular filtration rate (GFR) < 60 ml / min / 1.73 m2 without other signs of Kidney disease is a prevalent condition in the general population, however, it is not so common to find it in pregnant women. However, a history of kidney disease is associated with worse maternal and fetal outcomes. The standard formulas (CKD-EPI, Cockroft-Gault, and MDRD) used in the non-obstetric population have poor precision in determining glomerular filtration rate, because they underestimate kidney function by approximately 20 %. Creatinine clearance measured using 24-hour urine collections and serum creatinine estimate closely correlates with inulin clearance ("gold standard") and can be used during pregnancy. Early recognition of the disease, optimization of nephroprotection strategies, avoiding nephrotoxic drugs and specific treatment of the etiology, will guarantee a longer survival and fewer complications derived from kidney disease.
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Hui D, Hladunewich MA. Chronic Kidney Disease and Pregnancy. Obstet Gynecol.2019;133(6):1182-94.

Hladunewich MA. Chronic Kidney Disease and Pregnancy. Semin Nephrol. 2017;37(4):337-46.

Chan CT, Blankestijn PJ, Dember LM, Gallieni M, Harris DCH, Lok CE,et al.Iniciación a ladiálisis, elección de modalidad, acceso y prescripción: conclusiones de Conferencia de Con-troversia de KDIGO (Kidney Disease Improving Glo- bal Outcomes). Kidney International.2019;96:37-47.

KDIGO 2012 Clinical Practice Guideline for the Evaluation and Management of Chro-nic Kidney Disease. O cial Journal of the International Society of Nephrology. 2013 [ci-tado agosto 29 de 2020];3(1). Disponible en:

Hall M. Chronic renal disease and antenatal care. Best Pract Res Clin Obstet Gynaecol.2019;57:15-32.

Jones DC, Hayslett JP. Outcome of Pregnancy in Women with Moderate or Se-vere Renal Insu ciency. N Engl J Med. 1996335(4):226-32.

Koetje PMJL, Spaan JJ, Kooman JP, Spaanderman MEA, Peeters LL. Pregnancy Reduces theAccuracy of the Estimated Glomerular Filtration Rate Based on Cockroft-Gault and MDRDFormulas. Reprod Sci. 2011;18(5):456-62.

GBD Chronic Kidney Disease Collaboration. Global, regional, and national burden of chro-nic kidney disease, 1990-2017: a systematic analysis for the Global Burden of Disease Study 2017. Lancet. 2020;395(10225):709-33.

Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS,et al. Global Pre-valence of Chronic Kidney Disease - A Systematic Review and Meta-Analysis. PLoS One.2016;11(7):e0158765.

Piccoli GB, Alrukhaimi M, Liu ZH, Zakharova E, Levin A. What we know and do notknow about women and kidney diseases; Questions unanswered and answers unquestio-ned: Re ection on World Kidney Day and International Woman’s Day. Braz J Med Biol Res.2018;51(7):e7315.

He Y, Liu J, Cai Q, Lv J, Yu F, Chen Q,et al. The pregnancy outcomes in patients with stage3-4 chronic kidney disease and the effects of pregnancy in the long-term kidney function. JNephrol. 2018;31(6):953-60.

Fitzpatrick A, Mohammadi F, Jesudason S. Managing pregnancy in chronic kidney di-sease: improving outcomes for mother and baby. Int J Womens Health. 2016;8:273-85.

Munkhaugen J, Lydersen S, Romundstad PR, Wideroe TE, Vikse BE, Hallan S. Kidneyfunction and future risk for adverse pregnancy outcomes: a population- based study fromHUNT II, Norway. Nephrol Dial Transplant. 2009;24(12):3744-50.

Williams D, Davison J. Chronic kidney disease in pregnancy. BMJ. 2008;336(7637):211-5.

Gonzalez-Suarez ML, Kattah A, Grande JP, Garovic V. Renal Disorders in Pregnancy: CoreCurriculum 2019. Am J Kidney Dis. 2019;73(1):119-30.

Rojas WG, Cantillo JJ, Cantillo MJ. Enfermedad renal crónica y embarazo. Un desafío enla atención clínica y desenlace obstétrico. Acta Médica Colomb. 2015;40(4):7

Tong A, Jesudason S, Craig JC, Winkelmayer WC. Perspectives on pregnancy in womenwith chronic kidney disease: systematic review of qualitative studies. Nephrol Dial Trans-plant. 2015;30(4):652-61.

Piccoli GB, Cabiddu G, Attini R, Vigotti FN, Maxia S, Lepori N,et al.Risk of AdversePregnancy Outcomes in Women with CKD. J Am Soc Nephrol. 2015;26(8):2011-22.

Ibarra-Hernández M, Jiménez-Alvarado PM, Albarrán-López P, Botello- Ramírez SA. En-fermedad renal crónica durante el embarazo. Revista Médica MD. 2015;6(2):119-25

Hladunewich MA, Vella J, August P. Pregnancy in women with nondialysis chronic kid-ney disease. UpToDate. 2020

Castellanos-Castillo Y, Fong-Estrada JA, Vázquez-Trigo JM, Fong JO. Marcadores de da-ño renal en pacientes con factores de riesgo de enfermedad renal crónica. MEDISAN.2018;22(2):142-8

Zuleta R, Gerado W. Enfermedad renal crónica y embarazo, descripción clínica y desen-lace obstétrico de una serie de casos. Bogotá D.C.: Universidad nacional de Colombia; 2015

Wu CC, Chen SH, Ho CH, Liang FW, Chu CC, Wang HY,et al.End-stage renal diseaseafter hypertensive disorders in pregnancy. Am J Obstet Gynecol. 2014;210(2):147.e1-8.

Piccoli GB, Daidola G, Attini R, Parisi S, Fassio F, Naretto C,et al.Kidney biopsy in preg-nancy: evidence for counselling? A systematic narrative review. BJOG. 2013;120(4):412-27.

Eswarappa M, Rakesh M, Sonika P, Snigdha K, Midhun M, Kaushik K,et al.Spectrumof renal injury in pregnancy-induced hypertension: Experience from a single center in In-dia. Saudi J Kidney Dis Transplant. 2017;28(2):279-84.

Lopera-Medina MM. La enfermedad renal crónica en Colombia: necesidades en saludy respuesta del Sistema General de Seguridad Social en Salud. Rev. Gerenc. Polít. Salud.2016;15(30):212-33.

Krajewski CM, Geetha D, Gomez-Lobo V. Contraceptive Options for Women With a His-tory of Solid-Organ Transplantation. Transplantation. 2013;95(10):1183- 6.

Holley JL, Schmidt RJ. Changes in Fertility and Hormone Replacement Therapy in KidneyDisease. Adv Chronic Kidney Dis. 2013;20(3):240-5.

Piccoli GB, Cabiddu G, Attini R, Vigotti F, Fassio F, Rolfo A,et al.Pregnancy in ChronicKidney Disease: questions and answers in a changing panorama. Best Pract Res Clin ObstetGynaecol. 2015;29(5):625-42.

Mol BWJ, Roberts CT, Thangaratinam S, Magee LA, de Groot CJM, Hofmeyr GJ.Pre-eclampsia. Lancet. 2016;387(10022):999-1011.

Magee LA, von Dadelszen P, Rey E, Ross S, Asztalos E, Murphy KE,et al.Less-Tight versusTight Control of Hypertension in Pregnancy. N Engl J Med. 2015;372(24):407-17.

Khaing W, Vallibhakara SAO, Tantrakul V, Vallibhakara O, Rattanasiri S, McEvoy M,etal.Calcium and Vitamin D Supplementation for Prevention of Preeclampsia: A SystematicReview and Network Meta-Analysis. Nutrients. 2017;9(10):1141.

Rolnik DL, Wright D, Poon LC, O’Gorman N, Syngelaki A, de Paco-Matallana C, et al.Aspirin versus Placebo in Pregnancies at High Risk for Preterm Preeclampsia. N Engl JMed. 2017;377(7):613-22.

Piccoli GB, Fassio F, Attini R, Parisi S, Biolcati M, Ferraresi M,et al.Pregnancy in CKD:whom should we follow and why? Nephrol Dial Transplant. 2012;27(suppl 3):iii111-8.

Imbasciati E, Gregorini G, Cabiddu G, Gammaro L, Ambroso G, Del Giudice A,et al. Preg-nancy in CKD Stages 3 to 5: Fetal and Maternal Outcomes. Am J Kidney Dis. 2007;49(6):753-62.

Onder S, Akbar S, Schmidt RJ. Reproductive Endocrinology in Chronic Kidney DiseasePatients: New Approaches to Old Challenges. Semin Dial. 2016;29(6):447-57.

Webster P, Lightstone L, McKay DB, Josephson MA. Pregnancy in chronic kidney diseaseand kidney transplantation. Kidney Int. 2017;91(5):1047-56.

and Sau A, Clarke S, Bass J, Kaiser A, Marinaki A, Nelson-Piercy C. Azathioprine breast-feeding: is it safe? BJOG. 2007;114(4):498-501.

Bramham K, Chusney G, Lee J, Lightstone L, Nelson-Piercy C. Breastfeeding and Ta-crolimus: Serial Monitoring in Breast-Fed and Bottle-Fed Infants. Clin J Am Soc Nephrol.2013;8(4):563-7.

Hoeltzenbein M, Elefant E, Vial T, Finkel-Pekarsky V, Stephens S, Clementi M,et al.Tera-togenicity of mycophenolate con rmed in a prospective study of the European Network ofTeratology Information Services. Am J Med Genet A. 2012;158A(3):588-96.

Anderka MT, Lin AE, Abuelo DN, Mitchell AA, Rasmussen SA. Reviewing the evidencefor mycophenolate mofetil as a new teratogen: Case report and review of the literature. AmJ Med Genet A. 2009;149A(6):1241-8.

Clowse MEB, Magder L, Witter F, Petri M. Hydroxychloroquine in lupus pregnancy. Arth-ritis Rheum. 2006;54(11):3640-7.

Sebestyen A, Varbiro S, Sara L, Deak G, Kerkovits L, Szabo I,et al.Successful Managementof Pregnancy with Nephrotic Syndrome due to Preexisting Membranous Glomerulonephri-tis: A Case Report. Fetal Diagn Ther. 2008;24(3):186- 9.

Barbour SJ, Greenwald A, Djurdjev O, Levin A, Hladunewich MA, Nachman PH,et al.Disease-speci c risk of venous thromboembolic events is increased in idiopathic glomeru-lonephritis. Kidney Int. 2012;81(2):190-5.

Neeland IJ, Salahuddin U, McGuire DK. A Safety Evaluation of Empagli ozin for theTreatment of Type 2 Diabetes. Expert Opin Drug Saf. 2016;15(3):393-402.

Shahir AK, Briggs N, Katsoulis J, Levidiotis V. An observational outcomes study from1966-2008, examining pregnancy and neonatal outcomes from dialysed women using datafrom the ANZDATA Registry: Nephrology (Carlton). 2013;18(4):276-84.

Piccoli GB, Minelli F, Versino E, Cabiddu G, Attini R, Vigotti FN,et al.Pregnancyin dialysis patients in the new millennium: a systematic review and meta- regressionanalysis correlating dialysis schedules and pregnancy outcomes. Nephrol Dial Transplant.2016;31(11):1915-34.

Hladunewich MA, Hou S, Odutayo A, Cornelis T, Pierratos A, Goldstein M,et al.Intensi-ve Hemodialysis Associates with Improved Pregnancy Outcomes: A Canadian and United States Cohort Comparison. J Am Soc Nephrol. 2014;25(5):1103-9.

Hladunewich MA, August P, Vella J. Pregnancy in women on dialysis. UpToDate. 2020

Tangren J, Nadel M, Hladunewich MA. Pregnancy and End-Stage Renal Disease. BloodPurif. 2018;45(1-3):194-200.

McKay DB, Josephson MA. Pregnancy in Recipients of Solid Organs — Effects on Mot-her and Child. N Engl J Med. 2006;354(12):1281-93.

Wyld ML, Clayton PA, Jesudason S, Chadban SJ, Alexander SI. Pregnancy Outcomes forKidney Transplant Recipients. Am J Transplant. 2013;13(12):3173- 82.

Kim H, Jeong JC, Yang J, Yang WS, Ahn C, Han DJ,et al.The optimal therapy of calcineu-rin inhibitors for pregnancy in kidney transplantation. Clin Transplant. 2015;29(2):142-8.

Sifontis NM, Coscia LA, Constantinescu S, Lavelanet AF, Moritz MJ, Armenti VT. Preg-nancy Outcomes in Solid Organ Transplant Recipients With Exposure to Mycopheno-late Mofetil or Sirolimus. Transplantation. 2006;82(12):1698-702.

Rao S, Ghanta M, Moritz MJ, Constantinescu S. Long-Term Functional Recovery, Qua-lity of Life, and Pregnancy After Solid Organ Transplantation. Med Clin North Am.2016;100(3):613-29.

Deshpande NA, James NT, Kucirka LM, Boyarsky BJ, Garonzik-Wang JM, Montgo-mery RA,et al.Pregnancy Outcomes in Kidney Transplant Recipients: A Systematic Re-view and Meta-Analysis. Am J Transplant. 2011;11(11):2388-404.

Josephson MA, McKay DB. Pregnancy and Kidney Transplantation. Semin Nephrol.2011;31(1):100-10.

Durán-Alcaraz CL, Reyes-Paredes N. Enfermedades renales y embarazo. Rev Hosp GralDr M Gea González. 2006;7(2):82-9.

Díaz JPO, Hernández RC, Mayo JD, Rodríguez RAO, Pérez RT. Diagnóstico, Evaluación yManejo de la Enfermedad Renal en el Embarazo. Rev Haban Cienc Méd. 2016;15(5):834-58.

Zhang JJ, Ma XX, Hao L, Liu LJ, Lv JC, Zhang H. A Systematic Review and Meta-Analysisof Outcomes of Pregnancy in CKD and CKD Outcomes in Pregnancy. Clin J Am Soc Neph-rol. 2015;10(11):1964-78.

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