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Challenges in managing pregnancy in underserved women with chronic kidney disease

American Journal of Nephrology Apr 18, 2019

Ibarra-Hernandez M, et al. - While chronic kidney disease (CKD) is a public health issue in Mexico, researchers in this country have analyzed outcomes in pregnant women with CKD. In a prospective cohort of poor, pregnant women with CKD, they report maternal-fetal outcomes and compare outcomes with those of pregnant women without CKD. In CKD patients, prematurity was more common than controls and in patients needed dialysis (HD-CKD) was higher than in CKD patients did not require dialysis (non-HD CKD). Compared to controls, birth weight was lower in CKD. In CKD pregnancies, logistic regression showed a higher risk of preeclampsia than in controls, but was not affected by age, parity, CKD stage, or dialysis need during pregnancy. Overall, they concluded that underserved CKD Mexican women during pregnancy have a high rate of adverse maternal-fetal outcomes. The risk in patients requiring dialysis during pregnancy may be higher, many of whom remained dependent on dialysis after delivery.
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