Abstract: FR-PO862
The Effect of Pregnancy and Delivery on Renal Prognosis in Patients with Autosomal Dominant Polycystic Kidney Disease
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
Author
- Oba, Yuki, Toranomon Byoin Bunin, Kawasaki, Kanagawa, Japan
Background
Autosomal dominant polycystic kidney disease (ADPKD) is a frequent inherited renal disease, which is caused by PKD1 and PKD2 gene abnormalities and results in the progressive development and enlargement of numerous cysts in the bilateral kidneys, leading to progressive deterioration of renal function and end-stage renal failure. It has been reported that the pregnancy and delivery rates of women with ADPKD are similar to those without it in terms of fertility, miscarriage, stillbirth, and fetal complications. On the other hand, it has also been reported that the hypertensive disorders of pregnancy (HDP) are higher and the risk of renal failure is higher in women with ADPKD. This result may lead ADPKD women who wish to have a baby to hesitate in pregnancy and delivery. This study aims to determine whether the development of HDP affects renal function after delivery in women with ADPKD.
Methods
We performed a questionnaire on pregnancy and delivery to obtain clinical data and circumstances around women with ADPKD. The primary outcome was renal failure, with or without induction of dialysis. Survival analysis was performed to evaluate whether the primary endpoint is HDP with Cox proportional hazards analysis. Factors associated with the risk of the primary outcome will be evaluated using univariate and multivariate logistic analysis.
Results
One hundred eighty-three ADPKD women (including 100 patients on hemodialysis) were enrolled in this study. The median age was 58.6 years. The mean age at first delivery was 26.9 years. The average number of births was 2.5. the mean duration from the first delivery to dialysis is 31.7 years. The age of induction of dialysis was 54.4 years. Eighteen percent of the patients developed HDP at the time of first delivery, and 71.4% of the women with a history of HDP developed HDP at the time of second delivery. Although the incidence of HDP was higher than that of the general population in Japan, there was no difference in cumulative renal survival between patients with HDP (n=28) and those without (n=148). (p=0.27, Log-rank test). Multivariate analysis also showed that the presence or absence of HDP was not a risk for poor renal prognosis.
Conclusion
In female patients with ADPKD, the presence of HDP does not affect renal prognosis and accelerate renal failure.