open access

Vol 14, No 1 (2021)
Guidelines / Expert consensus
Published online: 2021-10-06
Get Citation

Polish Society of Nephrology Working Group — management of pregnant women with chronic kidney disease

Magdalena Durlik1, Marcin Adamczak, Marcin Adamczak, Ilona Kurnatowska, Ilona Kurnatowska, Tomasz Stompór, Tomasz Stompór
Renal Disease and Transplantation Forum 2021;14(1).
Affiliations
  1. The Clinic of Transplantation Medicine, Nephrology and Internal Diseases, Medical University of Warsaw, Poland

open access

Vol 14, No 1 (2021)
Poglądy, stanowiska, zalecenia, standardy i opinie
Published online: 2021-10-06

Abstract

Not available

Abstract

Not available
Get Citation

Keywords

pregnancy, chronic kidney disease, primary and secondary nephropathy, immunosuppressive drugs, hypertension, urinary tract infections, renal transplantation, genetic disorders of the kidney, acute kidney injury

About this article
Title

Polish Society of Nephrology Working Group — management of pregnant women with chronic kidney disease

Journal

Renal Disease and Transplantation Forum

Issue

Vol 14, No 1 (2021)

Article type

Guidelines / Expert consensus

Published online

2021-10-06

Bibliographic record

Renal Disease and Transplantation Forum 2021;14(1).

Keywords

pregnancy
chronic kidney disease
primary and secondary nephropathy
immunosuppressive drugs
hypertension
urinary tract infections
renal transplantation
genetic disorders of the kidney
acute kidney injury

Authors

Magdalena Durlik
Marcin Adamczak
Marcin Adamczak
Ilona Kurnatowska
Ilona Kurnatowska
Tomasz Stompór
Tomasz Stompór

References (77)
  1. Gonzalez Suarez ML, Kattah A, Grande JP, et al. Renal Disorders in Pregnancy: Core Curriculum 2019. Am J Kidney Dis. 2019; 73(1): 119–130.
  2. Piccoli GB, Zakharova E, Attini R, et al. Pregnancy in Chronic Kidney Disease: Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Different CKD Stages and Phases. J Clin Med. 2018; 7(11).
  3. Wiles KS, Nelson-Piercy C, Bramham K, et al. Pre-pregnancy counselling for women with chronic kidney disease: a retrospective analysis of nine years' experience. BMC Nephrol. 2015; 16(3): 28–184.
  4. Piccoli GB, Attini R, Vasario E, et al. Pregnancy and chronic kidney disease: a challenge in all CKD stages. Clin J Am Soc Nephrol. 2010; 5(5): 844–855.
  5. Zhang JJ, Ma XX, Hao Li, et al. A Systematic Review and Meta-Analysis of Outcomes of Pregnancy in CKD and CKD Outcomes in Pregnancy. Clin J Am Soc Nephrol. 2015; 10(11): 1964–1978.
  6. Piccoli GB, Cabiddu G, Attini R, et al. Risk of Adverse Pregnancy Outcomes in Women with CKD. J Am Soc Nephrol. 2015; 26(8): 2011–2022.
  7. Gruber MF. Food and Drug Administration, HHS. Content and format of labeling for human prescription drug and biological products; requirements for pregnancy and lactation labeling. Final rule. Fed Regist. 2014; 79(233): 72063–72103.
  8. Ponticelli C, Moroni G. Fetal Toxicity of Immunosuppressive Drugs in Pregnancy. J Clin Med. 2018; 7(12).
  9. Immunosuppressants. Reactions Weekly. 2018; 1732(1): 196–196.
  10. Hebert MF, Zheng S, Hays K, et al. Interpreting tacrolimus concentrations during pregnancy and postpartum. Transplantation. 2013; 95(7): 908–915.
  11. King RW, Baca MJ, Armenti VT, et al. Pregnancy Outcomes Related to Mycophenolate Exposure in Female Kidney Transplant Recipients. Am J Transplant. 2017; 17(1): 151–160.
  12. Tykarski A, Filipiak KJ, Januszewicz A, et al. Zasady postępowania w nadciśnieniu tętniczym — 2019 rok. Wytyczne Polskiego Towarzystwa nienia iczego. Nadciś Tętn Prakt. 2019; 5: 1–84.
  13. Prejbisz A, Dobrowolski P, Kosiński P, et al. Management of hypertension in pregnancy: prevention, diagnosis, treatment and long‑term prognosis. Kardiol Pol. 2019; 77(7-8): 757–806.
  14. Piccoli GB, Cabiddu G, Attini R, et al. Hypertension in CKD Pregnancy: a Question of Cause and Effect (Cause or Effect? This Is the Question). Curr Hypertens Rep. 2016; 18(5): 35.
  15. Hall M. Pregnancy in Women With CKD: A Success Story. Am J Kidney Dis. 2016; 68(4): 633–639.
  16. Gonzalez Suarez ML, Kattah A, Grande JP, et al. Renal Disorders in Pregnancy: Core Curriculum 2019. Am J Kidney Dis. 2019; 73(1): 119–130.
  17. Krane NK, Hamrahian M. Pregnancy: kidney diseases and hypertension. Am J Kidney Dis. 2007; 49(2): 336–345.
  18. Zhang JJ, Ma XX, Hao Li, et al. A Systematic Review and Meta-Analysis of Outcomes of Pregnancy in CKD and CKD Outcomes in Pregnancy. Clin J Am Soc Nephrol. 2015; 10(11): 1964–1978.
  19. Bateman BT, Bansil P, Hernandez-Diaz S, et al. Prevalence, trends, and outcomes of chronic hypertension: a nationwide sample of delivery admissions. Am J Obstet Gynecol. 2012; 206(2): 134.e1–134.e8.
  20. Coca Payeras A, Williams B, Mancia G, et al. ESC Scientific Document Group . 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39(33): 3021–3104.
  21. Bello NA, Miller E, Cleary K, et al. Out of Office Blood Pressure Measurement in Pregnancy and the Postpartum Period. Curr Hypertens Rep. 2018; 20(12): 101.
  22. Magee LA, von Dadelszen P, Rey E, et al. Less-tight versus tight control of hypertension in pregnancy. N Engl J Med. 2015; 372(5): 407–417.
  23. Webster LM, Conti-Ramsden F, Seed PT, et al. Impact of Antihypertensive Treatment on Maternal and Perinatal Outcomes in Pregnancy Complicated by Chronic Hypertension: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2017; 6(5).
  24. Magee LA, von Dadelszen P, Singer J, et al. CHIPS Study Group*. The CHIPS Randomized Controlled Trial (Control of Hypertension in Pregnancy Study): Is Severe Hypertension Just an Elevated Blood Pressure? Hypertension. 2016; 68(5): 1153–1159.
  25. Silversides CK, Grewal J, Mason J, et al. Cardiac Disease in Pregnancy (CARPREG) Investigators. Prospective multicenter study of pregnancy outcomes in women with heart disease. Circulation. 2001; 104(5): 515–521.
  26. Hanson MA, Bardsley A, De-Regil LM, et al. The International Federation of Gynecology and Obstetrics (FIGO) recommendations on adolescent, preconception, and maternal nutrition: "Think Nutrition First". Int J Gynaecol Obstet. 2015; 131 Suppl 4: S213–S253.
  27. Cockburn J, Ounsted M, Moar VA, et al. FINAL REPORT OF STUDY ON HYPERTENSION DURING PREGNANCY: THE EFFECTS OF SPECIFIC TREATMENT ON THE GROWTH AND DEVELOPMENT OF THE CHILDREN. The Lancet. 1982; 319(8273): 647–649.
  28. Hoeltzenbein M, Beck E, Fietz AK, et al. Pregnancy Outcome After First Trimester Use of Methyldopa: A Prospective Cohort Study. Hypertension. 2017; 70(1): 201–208.
  29. American College of Obstetricians and Gynecologists' Committee on Practice Bulletins—Obstetrics. ACOG Practice Bulletin No. 203 Summary: Chronic Hypertension in Pregnancy. Obstet Gynecol. 2019; 133(1): 215–219.
  30. Clark SM, Dunn HE, Hankins GDV. A review of oral labetalol and nifedipine in mild to moderate hypertension in pregnancy. Semin Perinatol. 2015; 39(7): 548–555.
  31. Kurtzman JL, Thorp JM, Spielman FJ, et al. Do nifedipine and verapamil potentiate the cardiac toxicity of magnesium sulfate? Am J Perinatol. 1993; 10(6): 450–452.
  32. Magee LA, von Dadelszen P, Singer J, et al. CHIPS Study Group. Control of Hypertension In Pregnancy Study randomised controlled trial-are the results dependent on the choice of labetalol or methyldopa? BJOG. 2016; 123(7): 1135–1141.
  33. Magee LA, Pels A, Helewa M, et al. SOGC Hypertension Guideline Committee, Canadian Hypertensive Disorders of Pregnancy Working Group. Diagnosis, evaluation, and management of the hypertensive disorders of pregnancy: executive summary. J Obstet Gynaecol Can. 2014; 36(5): 416–441.
  34. Krane NK, Hamrahian M. Pregnancy: kidney diseases and hypertension. Am J Kidney Dis. 2007; 49(2): 336–345.
  35. Piccoli GB, Cabiddu G, Attini R, et al. Risk of Adverse Pregnancy Outcomes in Women with CKD. J Am Soc Nephrol. 2015; 26(8): 2011–2022.
  36. Blom K, Odutayo A, Bramham K, et al. Pregnancy and Glomerular Disease: A Systematic Review of the Literature with Management Guidelines. Clin J Am Soc Nephrol. 2017; 12(11): 1862–1872.
  37. Wang F, Lu JD, Zhu Y, et al. Renal Outcomes of Pregnant Patients with Immunoglobulin A Nephropathy: A Systematic Review and Meta-Analysis. Am J Nephrol. 2019; 49(3): 214–224.
  38. Gonzalez Suarez ML, Kattah A, Grande JP, et al. Renal Disorders in Pregnancy: Core Curriculum 2019. Am J Kidney Dis. 2019; 73(1): 119–130.
  39. Li Y, Wang W, Wang Y, et al. Fetal Risks and Maternal Renal Complications in Pregnancy with Preexisting Chronic Glomerulonephritis. Med Sci Monit. 2018; 24: 1008–1016.
  40. De Castro I, Easterling TR, Bansal N, et al. Nephrotic syndrome in pregnancy poses risks with both maternal and fetal complications. Kidney Int. 2017; 91(6): 1464–1472.
  41. Oliverio AL, Zee J, Mariani LH, et al. Renal Complications in Pregnancy Preceding Glomerulonephropathy Diagnosis. Kidney Int Rep. 2019; 4(1): 159–162.
  42. Hladunewich MA, Bramham K, Jim B, et al. Managing glomerular disease in pregnancy. Nephrol Dial Transplant. 2017; 32(suppl_1): i48–i56.
  43. Wiles K, Chappell L, Clark K, et al. Clinical practice guideline on pregnancy and renal disease. BMC Nephrol. 2019; 20(1): 401.
  44. Wiles KS, Nelson-Piercy C, Bramham K, et al. Pre-pregnancy counselling for women with chronic kidney disease: a retrospective analysis of nine years' experience. BMC Nephrol. 2015; 16(3): 28–184.
  45. Barbour SJ, Greenwald A, Djurdjev O, et al. Disease-specific risk of venous thromboembolic events is increased in idiopathic glomerulonephritis. Kidney Int. 2012; 81(2): 190–195.
  46. Basude S, Hein C, Curtis SL, et al. Low-molecular-weight heparin or warfarin for anticoagulation in pregnant women with mechanical heart valves: what are the risks? A retrospective observational study. BJOG. 2012; 119(8): 1008–13; discussion 1012.
  47. Kamel H, Navi BB, Sriram N, et al. Risk of a thrombotic event after the 6-week postpartum period. N Engl J Med. 2014; 370(14): 1307–1315.
  48. Bateman BT, Hernandez-Diaz S, Fischer MA, et al. Statins and congenital malformations: cohort study. BMJ. 2015; 350: h1035.
  49. Colla L, Diena D, Rossetti M, et al. Immunosuppression in pregnant women with renal disease: review of the latest evidence in the biologics era. J Nephrol. 2018; 31(3): 361–383.
  50. Webster P, Lightstone L, McKay DB, et al. Pregnancy in chronic kidney disease and kidney transplantation. Kidney Int. 2017; 91(5): 1047–1056.
  51. Shah S, Verma P. Overview of Pregnancy in Renal Transplant Patients. Int J Nephrol. 2016; 2016: 4539342.
  52. Garcia-Donaire JA, Acevedo M, Gutiérrez MJ, et al. Tacrolimus as basic immunosuppression in pregnancy after renal transplantation. A single-center experience. Transplant Proc. 2005; 37(9): 3754–3755.
  53. Zheng S, Easterling TR, Umans JG, et al. Pharmacokinetics of tacrolimus during pregnancy. Ther Drug Monit. 2012; 34(6): 660–670.
  54. Vanhove T, Annaert P, Kuypers DRJ. Clinical determinants of calcineurin inhibitor disposition: a mechanistic review. Drug Metab Rev. 2016; 48(1): 88–112.
  55. Lu TYT, Ng KP, Cambridge G, et al. A retrospective seven-year analysis of the use of B cell depletion therapy in systemic lupus erythematosus at University College London Hospital: the first fifty patients. Arthritis Rheum. 2009; 61(4): 482–487.
  56. Götestam Skorpen C, Hoeltzenbein M, Tincani A, et al. The EULAR points to consider for use of antirheumatic drugs before pregnancy, and during pregnancy and lactation. Ann Rheum Dis. 2016; 75(5): 795–810.
  57. Constantinescu S, Pai A, Coscia L, et al. Breast-feeding after transplantation. Best Practice & Research Clinical Obstetrics & Gynaecology. 2014; 28(8): 1163–1173.
  58. Bramham K. Diabetic Nephropathy and Pregnancy. Semin Nephrol. 2017; 37(4): 362–369.
  59. Ringholm L, Damm JA, Vestgaard M, et al. Diabetic Nephropathy in Women With Preexisting Diabetes: From Pregnancy Planning to Breastfeeding. Curr Diab Rep. 2016; 16(2): 12.
  60. Mathiesen ER, Ringholm L, Feldt-Rasmussen Bo, et al. Obstetric nephrology: pregnancy in women with diabetic nephropathy--the role of antihypertensive treatment. Clin J Am Soc Nephrol. 2012; 7(12): 2081–2088.
  61. Spotti D. Pregnancy in women with diabetic nephropathy. J Nephrol. 2019; 32(3): 379–388.
  62. American Diabetes Association. 14. Management of Diabetes in Pregnancy: . Diabetes Care. 2019; 42(Suppl 1): S165–S172.
  63. Zalecenia kliniczne dotyczące postępowania u chorych na cukrzycę, 2019. Stanowisko Polskiego Towarzystwa ogicznego. Diabetol Prakt. 2019; 5: 1–102.
  64. Zhang JJ, Ma XX, Hao Li, et al. A Systematic Review and Meta-Analysis of Outcomes of Pregnancy in CKD and CKD Outcomes in Pregnancy. Clin J Am Soc Nephrol. 2015; 10(11): 1964–1978.
  65. Hanly J. The Nervous System in Systemic Lupus Erythematosus. Systemic Lupus Erythematosus. 2001: 414–428.
  66. Sammaritano LR, Yelnik CM, Porter TF, et al. Brief Report: Changes in Antiphospholipid Antibody Titers During Pregnancy: Effects on Pregnancy Outcomes. Arthritis Rheumatol. 2016; 68(8): 1964–1969.
  67. Buyon JP, Kim MY, Guerra MM, et al. Predictors of Pregnancy Outcomes in Patients With Lupus: A Cohort Study. Ann Intern Med. 2015; 163(3): 153–163.
  68. Moroni G, Doria A, Giglio E, et al. Maternal outcome in pregnant women with lupus nephritis. A prospective multicenter study. J Autoimmun. 2016; 74: 194–200.
  69. Moroni G, Doria A, Giglio E, et al. Fetal outcome and recommendations of pregnancies in lupus nephritis in the 21st century. A prospective multicenter study. J Autoimmun. 2016; 74: 6–12.
  70. Andreoli L, Bertsias GK, Agmon-Levin N, et al. EULAR recommendations for women's health and the management of family planning, assisted reproduction, pregnancy and menopause in patients with systemic lupus erythematosus and/or antiphospholipid syndrome. Ann Rheum Dis. 2017; 76(3): 476–485.
  71. Cabiddu G, Castellino S, Gernone G, et al. A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy. J Nephrol. 2016; 29(3): 277–303.
  72. Buyon JP, Kim MY, Guerra MM, et al. Kidney Outcomes and Risk Factors for Nephritis (Flare/) in a Multiethnic Cohort of Pregnant Patients with Lupus. Clin J Am Soc Nephrol. 2017; 12(6): 940–946.
  73. Blom K, Odutayo A, Bramham K, et al. Pregnancy and Glomerular Disease: A Systematic Review of the Literature with Management Guidelines. Clin J Am Soc Nephrol. 2017; 12(11): 1862–1872.
  74. Soh MC, Nelson-Piercy C, Soh MC, et al. High-risk pregnancy and the rheumatologist. Rheumatology (Oxford). 2015; 54(4): 572–587.
  75. Gianfreda D, Quaglini S, Frontini G, et al. Does pregnancy have any impact on long term damage accrual and on the outcome of lupus nephritis? J Autoimmun. 2017; 84: 46–54.
  76. Machen L, Clowse MEB. Vasculitis and Pregnancy. Rheum Dis Clin North Am. 2017; 43(2): 239–247.
  77. Sangle SR, Vounotrypidis P, Briley A, et al. Pregnancy outcome in patients with systemic vasculitis: a single-centre matched case-control study. Rheumatology (Oxford). 2015; 54(9): 1582–1586.

Regulations

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.