Centre Hospitalier Le Mans, Avenue Roubillard 196, 7200, Le Mans, France.
Ibn Rochd University Hospital, Casablanca, Morocco.
J Nephrol. 2019 Dec;32(6):977-987. doi: 10.1007/s40620-019-00629-8. Epub 2019 Jul 17.
Preeclampsia (PE) and chronic kidney disease (CKD) are linked by an only partially known cause-effect relationship. Knowledge on prevalence of CKD in PE patients is needed for evaluating the diagnostic yield of nephrology work-up after PE.
The study was undertaken in the Centre Hospitalier Le Mans (CHM), setting of tertiary level obstetric service (about 3500 deliveries/year). PE was identified on hospital's discharge codes; after review, the study included 99 patients, 36 of which were also evaluated in Nephrology. A descriptive analysis was performed as appropriate. Logistic multiple regression tested the outcome "CKD diagnosis"; covariates that emerged as significant were selected; only singletons were included. Analysis was performed in SPSS. The ethics committee of the CHM approved the study.
Prevalence of CKD was 14%; CKD was in stage 1 in 8/14 (57%); 5 patients were in stage 2 (36%), 1 in stage 3 (7%). CKD was known or acknowledged in 1 case only. Diagnoses included reflux nephropathy-other malformations (5 cases), kidney stones-chronic pyelonephritis (3), PKD (1), interstitial nephropathy (2), diabetic nephropathy (1), albuminuria in metabolic syndrome (2). At the logistic regression analysis, preterm delivery [OR 7.849 (1.667-36.968)] and a baby normal for gestational age [> 10th centile; OR 6.193 (1.400-27.394)] were significantly correlated with the diagnosis of CKD.
Within the limits of a single-center study, our data quantify CKD as common in PE women and suggest the presence of a "CKD phenotype" characterised by preterm delivery and adequate growth, implying that CKD is compatible with good placental function up to the last phase of pregnancy.
子痫前期 (PE) 和慢性肾脏病 (CKD) 之间存在部分已知的因果关系。了解 PE 患者 CKD 的患病率对于评估 PE 后的肾脏病学检查的诊断效果很有必要。
该研究在勒芒中心医院 (CHM) 进行，这是一家三级产科服务机构（每年约有 3500 例分娩）。PE 是根据医院的出院代码确定的；经过审查，本研究纳入了 99 名患者，其中 36 名患者还在肾脏病科接受了评估。对适当的情况进行了描述性分析。逻辑多元回归测试了“CKD 诊断”的结果；选择了出现的显著协变量；仅纳入单胎。分析在 SPSS 中进行。CHM 的伦理委员会批准了该研究。
CKD 的患病率为 14%；14 例患者中，CKD 处于 1 期的有 8 例（57%）；5 例处于 2 期（36%），1 例处于 3 期（7%）。仅 1 例已知或承认 CKD。诊断包括反流肾病-其他畸形（5 例）、肾结石-慢性肾盂肾炎（3 例）、多囊肾病（1 例）、间质性肾炎（2 例）、糖尿病肾病（1 例）、代谢综合征伴白蛋白尿（2 例）。在逻辑回归分析中，早产 [OR7.849（1.667-36.968）] 和婴儿按胎龄正常生长 [>第 10 百分位；OR6.193（1.400-27.394）] 与 CKD 的诊断显著相关。
在单中心研究的范围内，我们的数据量化了 PE 女性 CKD 的常见程度，并提出了“CKD 表型”的存在，其特征为早产和适当的生长，这意味着 CKD 与良好的胎盘功能相容，直至妊娠的最后阶段。
