Abstract: FR-PO858
Characteristics and Outcomes of Patients with Pregnancy-Related ESKD
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
- Kucirka, Lauren M., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Angarita, Ana M., Thomas Jefferson University Sidney Kimmel Medical College, Philadelphia, Pennsylvania, United States
- Manuck, Tracy, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Boggess, Kim, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Derebail, Vimal K., The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Wood, Mollie Elizabeth, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
- Segev, Dorry L., New York University, New York, New York, United States
- Reynolds, Monica Lona, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
Background
The incidence of pregnancy-related AKI is increasing and associated with morbidity including progression to ESKD. We aimed to examine characteristics and clinical outcomes of patients with a pregnancy-related primary cause of ESKD(PR-ESKD).
Methods
We studied 183,640 reproductive-aged females with incident ESKD, 341 with PR-ESKD, from Jan 2000-Nov 2020 in USRDS. We compared baseline characteristics of those with PR-ESKD to the US birthing population using CDC natality data.We built multivariable Cox/competing risk models to examine 1)mortality, 2)access to kidney transplant(KT), and 3)time to KT after joining the waitlist between those with PR-ESKD and reproductive-age women with other causes of ESKD.
Results
Versus the general US birthing population, Black patients were overrepresented in PR-ESKD(31.9% vs. 16.7%). PR-ESKD had similar/lower hazards of mortality but significantly less acess to KT vs other causes of ESKD(Figure); this persisted in adjusted analyses(Table). Those with PR-ESKD were less likely to have nephrology care prior to ESKD-onset (aRR=0.47,95% CI:0.40-0.56).
Conclusion
Black patients are disproportionately affected by pregnancy-related ESKD. Our finding of reduced access to KT and pre-ESKD care highlight the need for improved postpartum and long-term support.