Kidney Week

Abstract: FR-PO869

Measurement of Kidney Function and Adverse Pregnancy Outcomes

Session Information

• Women's Health and Kidney Diseases
  November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2200 Women's Health and Kidney Diseases

Authors

• Lucas, Anika, Duke University School of Medicine, Durham, North Carolina, United States

Anika Lucas,

• Feng, Yixuan, Duke University School of Medicine, Durham, North Carolina, United States

Yixuan Feng,

• Wyatt, Christina M., Duke University School of Medicine, Durham, North Carolina, United States

Christina M. Wyatt,

• Goldstein, Benjamin A., Duke University School of Medicine, Durham, North Carolina, United States

Benjamin A. Goldstein,

Background

Although it is estimated that 3% of women of childbearing age have kidney disease, there are no guidelines for routinely testing patients for kidney disease in the United States. Our objectives included identifying patients who received 1^st and 2^nd trimester serum creatinine measurements and evaluating rates of adverse pregnancy outcomes by level of kidney function.

Methods

Pregnant patients with serum creatinine measurements in the 1^st and 2^nd trimesters of pregnancy were identified in the electronic health record from 2014 to 2019. The 2021 Chronic Kidney Disease Epidemiology Collaboration Equation was used to calculate estimated glomerular filtration rate. Patients were divided into eGFR strata based on previously established eGFR cutoffs. Adverse pregnancy outcomes of interest included low birth weight, preterm birth, gestational hypertension, preeclampsia and a composite outcome.

Results

We identified 6460 patients who had creatinine measurements in the 1^st trimester, representing 27% of patients receiving care during the 1^st trimester. We further identified 5268 patients with a 2^nd trimester creatinine, only 22% of patients receiving care in the 2^nd trimester. Patients who received 1^st trimester creatinine measurements were more likely to be <35 years old, Black and from disadvantaged areas. Patients with eGFR <90 ml/min/1.73 m² in the 1^st and 2^nd trimesters of pregnancy had the highest rates of preterm birth. Patients with eGFR>150 ml/min/1.73 m² had the highest rates of adverse outcomes, though a very small portion of the population.

Conclusion

Less than 1 in 3 patients had serum creatinine measurements available during the 1^st and 2^nd trimesters of pregnancy. More data is needed to evaluate the utility of creatinine measurements in pregnancy.

Funding

• Private Foundation Support