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A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant

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A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant. / Webster, Philip; Webster, Louise M; Cook, H Terence; Horsfield, Catherine; Seed, Paul T; Vaz, Raquel; Santos, Clara; Lydon, Isabelle; Homsy, Michele; Lightstone, Liz; Bramham, Kate.

In: Clinical journal of the American Society of Nephrology : CJASN, 09.12.2016.

Research output: Contribution to journalArticle

Harvard

Webster, P, Webster, LM, Cook, HT, Horsfield, C, Seed, PT, Vaz, R, Santos, C, Lydon, I, Homsy, M, Lightstone, L & Bramham, K 2016, 'A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant', Clinical journal of the American Society of Nephrology : CJASN. https://doi.org/10.2215/CJN.05610516

APA

Webster, P., Webster, L. M., Cook, H. T., Horsfield, C., Seed, P. T., Vaz, R., ... Bramham, K. (2016). A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant. Clinical journal of the American Society of Nephrology : CJASN. https://doi.org/10.2215/CJN.05610516

Vancouver

Webster P, Webster LM, Cook HT, Horsfield C, Seed PT, Vaz R et al. A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant. Clinical journal of the American Society of Nephrology : CJASN. 2016 Dec 9. https://doi.org/10.2215/CJN.05610516

Author

Webster, Philip ; Webster, Louise M ; Cook, H Terence ; Horsfield, Catherine ; Seed, Paul T ; Vaz, Raquel ; Santos, Clara ; Lydon, Isabelle ; Homsy, Michele ; Lightstone, Liz ; Bramham, Kate. / A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant. In: Clinical journal of the American Society of Nephrology : CJASN. 2016.

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@article{cee344ce02a54fcdabc0daf68ba831ad,
title = "A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant",
abstract = "BACKGROUND AND OBJECTIVES: For many women pregnancy is the first contact with health services, thus providing an opportunity to identify renal disease. This study compares causes and long-term renal outcomes of biopsy-proven renal disease identified during pregnancy or within 1 year postpartum, with nonpregnant women.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Native renal biopsies (1997-2012), in women of childbearing age (16 to <50 years), from 21 hospitals were studied. The pregnancy-related diagnosis group included those women with abnormal urinalysis/raised creatinine identified during pregnancy or within 1 year postpartum. Pregnancy-related and control biopsies were matched for age and ethnicity (black versus nonblack).RESULTS: One hundred and seventy-three pregnancy-related biopsies (19 antenatal, 154 postpregnancy) were identified and matched with 1000 controls. FSGS was more common in pregnancy-related biopsies (32.4{\%}) than controls (9.7{\%}) (P<0.001) but there were no differences in Columbia classification. Women with a pregnancy-related diagnosis were younger (32.1 versus 34.2 years; P=0.004) and more likely to be black (26.0{\%} versus 13.3{\%}; P<0.001) than controls, although there were no differences in ethnicities in women with FSGS. The pregnancy-related group (excluding antenatal biopsies) was more likely to have a decline in Chronic Kidney Disease Epidemiology Collaboration eGFR in the follow-up period than the control group (odds ratio, 1.67; 95{\%} confidence interval, 1.03 to 2.71; P=0.04), and this decline appeared to be more rapid (-1.33 versus -0.56 ml/min per 1.73 m(2) per year, respectively; P=0.045). However, there were no differences between groups in those who required RRT or who died.CONCLUSIONS: Pregnancy is an opportunity to detect kidney disease. FSGS is more common in women who have been pregnant than in controls, and disease identified in pregnancy or within 1 year postpartum is more likely to show a subsequent decline in renal function. Further work is required to determine whether pregnancy initiates, exacerbates, or reveals renal disease.",
author = "Philip Webster and Webster, {Louise M} and Cook, {H Terence} and Catherine Horsfield and Seed, {Paul T} and Raquel Vaz and Clara Santos and Isabelle Lydon and Michele Homsy and Liz Lightstone and Kate Bramham",
note = "Copyright {\circledC} 2016 by the American Society of Nephrology.",
year = "2016",
month = "12",
day = "9",
doi = "10.2215/CJN.05610516",
language = "English",
journal = "Clinical journal of the American Society of Nephrology : CJASN",
issn = "1555-9041",
publisher = "American Society of Nephrology",

}

RIS (suitable for import to EndNote) Download

TY - JOUR

T1 - A Multicenter Cohort Study of Histologic Findings and Long-Term Outcomes of Kidney Disease in Women Who Have Been Pregnant

AU - Webster, Philip

AU - Webster, Louise M

AU - Cook, H Terence

AU - Horsfield, Catherine

AU - Seed, Paul T

AU - Vaz, Raquel

AU - Santos, Clara

AU - Lydon, Isabelle

AU - Homsy, Michele

AU - Lightstone, Liz

AU - Bramham, Kate

N1 - Copyright © 2016 by the American Society of Nephrology.

PY - 2016/12/9

Y1 - 2016/12/9

N2 - BACKGROUND AND OBJECTIVES: For many women pregnancy is the first contact with health services, thus providing an opportunity to identify renal disease. This study compares causes and long-term renal outcomes of biopsy-proven renal disease identified during pregnancy or within 1 year postpartum, with nonpregnant women.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Native renal biopsies (1997-2012), in women of childbearing age (16 to <50 years), from 21 hospitals were studied. The pregnancy-related diagnosis group included those women with abnormal urinalysis/raised creatinine identified during pregnancy or within 1 year postpartum. Pregnancy-related and control biopsies were matched for age and ethnicity (black versus nonblack).RESULTS: One hundred and seventy-three pregnancy-related biopsies (19 antenatal, 154 postpregnancy) were identified and matched with 1000 controls. FSGS was more common in pregnancy-related biopsies (32.4%) than controls (9.7%) (P<0.001) but there were no differences in Columbia classification. Women with a pregnancy-related diagnosis were younger (32.1 versus 34.2 years; P=0.004) and more likely to be black (26.0% versus 13.3%; P<0.001) than controls, although there were no differences in ethnicities in women with FSGS. The pregnancy-related group (excluding antenatal biopsies) was more likely to have a decline in Chronic Kidney Disease Epidemiology Collaboration eGFR in the follow-up period than the control group (odds ratio, 1.67; 95% confidence interval, 1.03 to 2.71; P=0.04), and this decline appeared to be more rapid (-1.33 versus -0.56 ml/min per 1.73 m(2) per year, respectively; P=0.045). However, there were no differences between groups in those who required RRT or who died.CONCLUSIONS: Pregnancy is an opportunity to detect kidney disease. FSGS is more common in women who have been pregnant than in controls, and disease identified in pregnancy or within 1 year postpartum is more likely to show a subsequent decline in renal function. Further work is required to determine whether pregnancy initiates, exacerbates, or reveals renal disease.

AB - BACKGROUND AND OBJECTIVES: For many women pregnancy is the first contact with health services, thus providing an opportunity to identify renal disease. This study compares causes and long-term renal outcomes of biopsy-proven renal disease identified during pregnancy or within 1 year postpartum, with nonpregnant women.DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Native renal biopsies (1997-2012), in women of childbearing age (16 to <50 years), from 21 hospitals were studied. The pregnancy-related diagnosis group included those women with abnormal urinalysis/raised creatinine identified during pregnancy or within 1 year postpartum. Pregnancy-related and control biopsies were matched for age and ethnicity (black versus nonblack).RESULTS: One hundred and seventy-three pregnancy-related biopsies (19 antenatal, 154 postpregnancy) were identified and matched with 1000 controls. FSGS was more common in pregnancy-related biopsies (32.4%) than controls (9.7%) (P<0.001) but there were no differences in Columbia classification. Women with a pregnancy-related diagnosis were younger (32.1 versus 34.2 years; P=0.004) and more likely to be black (26.0% versus 13.3%; P<0.001) than controls, although there were no differences in ethnicities in women with FSGS. The pregnancy-related group (excluding antenatal biopsies) was more likely to have a decline in Chronic Kidney Disease Epidemiology Collaboration eGFR in the follow-up period than the control group (odds ratio, 1.67; 95% confidence interval, 1.03 to 2.71; P=0.04), and this decline appeared to be more rapid (-1.33 versus -0.56 ml/min per 1.73 m(2) per year, respectively; P=0.045). However, there were no differences between groups in those who required RRT or who died.CONCLUSIONS: Pregnancy is an opportunity to detect kidney disease. FSGS is more common in women who have been pregnant than in controls, and disease identified in pregnancy or within 1 year postpartum is more likely to show a subsequent decline in renal function. Further work is required to determine whether pregnancy initiates, exacerbates, or reveals renal disease.

U2 - 10.2215/CJN.05610516

DO - 10.2215/CJN.05610516

M3 - Article

C2 - 27940459

JO - Clinical journal of the American Society of Nephrology : CJASN

JF - Clinical journal of the American Society of Nephrology : CJASN

SN - 1555-9041

ER -

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