Effect of pregnancy on renal function in patients with moderate-to- severe diabetic renal insufficiency

摘要: OBJECTIVE Previous studies of patients with diabetic nephropathy and mild renal impairment have suggested no determination in function as a result pregnancy. The objective this study was to determine whether pregnancy may permanently worsen women moderate-to-severe insufficiency. RESEARCH DESIGN AND METHODS Eleven were identified dysfunction (creatinine [Cr] ≥ 124 μmol/l [1.4 mg/dl]) at onset by retrospective chart review. Alterations glomerular filtration rate estimated using linear regression the reciprocal Cr over time. An equal number nonpregnant premenopausal type 1 similar degrees served comparison group for decline potential contributing factors. RESULTS Mean serum rose from 159 (1.8 mg/dl) prepregnancy 221 (2.5 third trimester. Renal stable 27%, showed transient worsening demonstrated permanent 45%. Proteinuria increased 79%. Exacerbation hypertension or preeclampsia occurred 73%. Seven progressed dialysis 6–57 months postpartum, 71% (five seven) these cases attributed acceleration disease during Student9s t tests repeated-measures analysis variance support pregnancy-induced function. CONCLUSIONS In series, insufficiency found > 40% chance accelerated progression their