Baseline proteinuria level and adverse outcomes in pregnant women with chronic kidney disease: new evidence and a note of caution

About 3% of all pregnancies occur in patients with some degree of chronic kidney disease (CKD) and, in turn, CKD is a risk factor for developing hypertensive disorders of pregnancies (HDP) and unfavorable pregnancy outcomes, at both the maternal and fetal level. CKD is often characterized by protein...

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Bibliographic Details
Published in:Clinical kidney journal 2023-10, Vol.16 (10), p.1550-1552
Main Authors: Kervella, Delphine, Torreggiani, Massimo
Format: Article
Language:English
Subjects:
Chronic kidney failure
Development and progression
Hypertension
Life Sciences
Neonatology
Pregnancy
Pregnant women
Proteinuria
Risk factors
Type 2 diabetes
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Summary:About 3% of all pregnancies occur in patients with some degree of chronic kidney disease (CKD) and, in turn, CKD is a risk factor for developing hypertensive disorders of pregnancies (HDP) and unfavorable pregnancy outcomes, at both the maternal and fetal level. CKD is often characterized by proteinuria and proteinuria is a risk factor for HDP. However, even if the positive correlation between proteinuria and unfavorable pregnancy outcomes is well acknowledged, the degree of proteinuria associated with adverse outcomes is still a matter of debate. In this issue of the Journal, Li et al. present a retrospective study that shows that >1 g of proteinuria/day is associated with worse maternal outcomes while >2 g/day with worse fetal ones. This study gives proteinuria thresholds for unfavorable outcomes in pregnant CKD patients, but it should be kept in mind that there is a linear correlation between proteinuria and worse pregnancy outcomes, thus a strict surveillance during the entire gestation should be advised independently of the proteinuria level.
ISSN:2048-8505
2048-8513
DOI:10.1093/ckj/sfad136