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  • Pregnancy in renal transpla...
    Tebet, Jussara Leiko Sato; Kirsztajn, Gianna Mastroianni; Facca, Thais Alquezar; Nishida, Sonia K.; Pereira, Amelia Rodrigues; Moreira, Silvia Regina; Medina, José Osmar Pestana; Sass, Nelson

    Pregnancy hypertension, January 2019, 2019-Jan, 2019-01-00, 20190101, Letnik: 15
    Journal Article

    •Preeclampsia was the main cause of renal function decline at the end of pregnancy.•Podocyturia was not significantly correlated with other renal function markers.•Preeclampsia was the most common obstetric complication after renal transplants.•Albumin/creatinine ratios increased during pregnancy and puerperium.•Elevated albumin/creatinine ratio were associated with prematurity. We aimed to evaluate laboratory markers in women who got pregnant after renal transplantation. Cross-sectional prospective study. Renal function parameters and maternal and fetal data were assessed in renal transplant recipients. Forty-three women who got pregnant after renal transplantation (mean age, 28.5 years; mean gestational age, 35.6 weeks) were included. Most patients (53.5%) received a renal transplant from a deceased donor. Podocyturia was not significantly correlated with other renal function markers. Mean period from transplantation to pregnancy was approximately 5 years; this period was not associated with obstetric complications or changes in renal markers. A gradual increase was observed in the following parameters during pregnancy and puerperium: serum creatinine levels (P < 0.001), proteinuria (P < 0.001), urinary protein/creatinine ratio (P < 0.001), and albumin/creatinine ratio (P < 0.001). The sensitivity and specificity of protein/creatinine ratio in predicting preeclampsia were high (96.0% and 94.0%, respectively). Elevated serum creatinine levels, urinary albumin/creatinine ratio, and retinol-binding protein levels in the third trimester were associated with prematurity (P < 0.001). Preeclampsia was the main cause of renal function decline at the end of pregnancy (65.0% of cases). Approximately four (9.5%) pregnant women presented with premature rupture of membranes and 18 (42.0%) with a urinary tract infection. Proteinuria, urinary protein/creatinine ratio, and retinol-binding protein levels were elevated in patients with preeclampsia. Using these markers to assess renal function during pregnancy may be clinically useful for detecting and monitoring renal injury in renal transplant recipients.