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Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy

Pregnancy in kidney transplantation (KT) recipients has been challenging because of the high risk of maternal, fetal, and renal complications. Although patients with immunoglobulin A nephropathy (IgAN)-chronic kidney disease (CKD) are at a high risk for hypertension in pregnancy (HIP), the maternal...

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Autores principales: Oki, Rikako, Unagami, Kohei, Kakogawa, Jun, Beppu, Hiroko, Banno, Taro, Yagisawa, Takafumi, Kanzawa, Taichi, Hirai, Toshihito, Omoto, Kazuya, Kitajima, Kumiko, Shirakawa, Hiroki, Hoshino, Junichi, Takagi, Toshio, Ishida, Hideki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193387/
https://www.ncbi.nlm.nih.gov/pubmed/37213487
http://dx.doi.org/10.3389/ti.2023.11220
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author Oki, Rikako
Unagami, Kohei
Kakogawa, Jun
Beppu, Hiroko
Banno, Taro
Yagisawa, Takafumi
Kanzawa, Taichi
Hirai, Toshihito
Omoto, Kazuya
Kitajima, Kumiko
Shirakawa, Hiroki
Hoshino, Junichi
Takagi, Toshio
Ishida, Hideki
author_facet Oki, Rikako
Unagami, Kohei
Kakogawa, Jun
Beppu, Hiroko
Banno, Taro
Yagisawa, Takafumi
Kanzawa, Taichi
Hirai, Toshihito
Omoto, Kazuya
Kitajima, Kumiko
Shirakawa, Hiroki
Hoshino, Junichi
Takagi, Toshio
Ishida, Hideki
author_sort Oki, Rikako
collection PubMed
description Pregnancy in kidney transplantation (KT) recipients has been challenging because of the high risk of maternal, fetal, and renal complications. Although patients with immunoglobulin A nephropathy (IgAN)-chronic kidney disease (CKD) are at a high risk for hypertension in pregnancy (HIP), the maternal risk in KT recipients with IgAN as the etiology remains unclear. We retrospectively reviewed the medical records of pregnant KT recipients who delivered at our hospital. The incidence of maternal and fetal complications and the impact on kidney allografts between the group with IgAN as the primary kidney disease and the group with other primary diseases were compared. The analysis included 73 pregnancies in 64 KT recipients. The IgAN group had a higher incidence of HIP than the non-IgAN group (69% vs. 40%, p = 0.02). IgAN as primary kidney disease and interval from transplantation to conception were associated with HIP (OR 3.33 [1.11–9.92], p = 0.03, OR 0.83 [0.72–0.96], p < 0.01, respectively). The 20-year graft survival or prevention of CKD stage 5 in group with IgAN was lower than that in the group with other primary disease (p < 0.01). KT recipients should be informed of the risk of HIP and possibility of long-term worsening of postpartum renal function.
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spelling pubmed-101933872023-05-19 Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy Oki, Rikako Unagami, Kohei Kakogawa, Jun Beppu, Hiroko Banno, Taro Yagisawa, Takafumi Kanzawa, Taichi Hirai, Toshihito Omoto, Kazuya Kitajima, Kumiko Shirakawa, Hiroki Hoshino, Junichi Takagi, Toshio Ishida, Hideki Transpl Int Health Archive Pregnancy in kidney transplantation (KT) recipients has been challenging because of the high risk of maternal, fetal, and renal complications. Although patients with immunoglobulin A nephropathy (IgAN)-chronic kidney disease (CKD) are at a high risk for hypertension in pregnancy (HIP), the maternal risk in KT recipients with IgAN as the etiology remains unclear. We retrospectively reviewed the medical records of pregnant KT recipients who delivered at our hospital. The incidence of maternal and fetal complications and the impact on kidney allografts between the group with IgAN as the primary kidney disease and the group with other primary diseases were compared. The analysis included 73 pregnancies in 64 KT recipients. The IgAN group had a higher incidence of HIP than the non-IgAN group (69% vs. 40%, p = 0.02). IgAN as primary kidney disease and interval from transplantation to conception were associated with HIP (OR 3.33 [1.11–9.92], p = 0.03, OR 0.83 [0.72–0.96], p < 0.01, respectively). The 20-year graft survival or prevention of CKD stage 5 in group with IgAN was lower than that in the group with other primary disease (p < 0.01). KT recipients should be informed of the risk of HIP and possibility of long-term worsening of postpartum renal function. Frontiers Media S.A. 2023-05-04 /pmc/articles/PMC10193387/ /pubmed/37213487 http://dx.doi.org/10.3389/ti.2023.11220 Text en Copyright © 2023 Oki, Unagami, Kakogawa, Beppu, Banno, Yagisawa, Kanzawa, Hirai, Omoto, Kitajima, Shirakawa, Hoshino, Takagi and Ishida. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Oki, Rikako
Unagami, Kohei
Kakogawa, Jun
Beppu, Hiroko
Banno, Taro
Yagisawa, Takafumi
Kanzawa, Taichi
Hirai, Toshihito
Omoto, Kazuya
Kitajima, Kumiko
Shirakawa, Hiroki
Hoshino, Junichi
Takagi, Toshio
Ishida, Hideki
Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title_full Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title_fullStr Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title_full_unstemmed Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title_short Pregnancy Complications and Impact on Kidney Allograft After Kidney Transplantation in IgA Nephropathy
title_sort pregnancy complications and impact on kidney allograft after kidney transplantation in iga nephropathy
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10193387/
https://www.ncbi.nlm.nih.gov/pubmed/37213487
http://dx.doi.org/10.3389/ti.2023.11220
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