Abstract: FR-PO871
Practice Patterns of Nephrologists Who Care for Pregnant Patients with CKD
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
- Alamri, Nada, 1. Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
- Almomen, Mohammad, 1. Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
- Molnar, Amber O., 1. Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
- Clase, Catherine M., 1. Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
- Mathew, Anna T., 1. Division of Nephrology, McMaster University, Hamilton, Ontario, Canada
Background
Chronic kidney disease (CKD) increases adverse pregnancy events such as pre-eclampsia, preterm delivery, and progression of maternal CKD. While live birth rates among pregnant people with kidney disease have increased, these pregnancies remain a high risk, emphasizing the critical need for advanced understanding and management strategies. Data on Canadian nephrologist practice patterns and center-specific strategies to improve outcomes for pregnant people with CKD are limited. This study used survey methodology to assess practice patterns and policies in this area.
Methods
We conducted a national, cross-sectional survey to assess the practice patterns of Canadian nephrologists caring for pregnant people with CKD. Following literature review, we developed a list of items covering key aspects of CKD management in people who are pregnant, including pre-conception counseling, multispecialty team collaboration and post-transplant care. Items were refined and deduplicated through iterative review by team members. The survey was distributed through professional networks. The responses were analyzed descriptively and key findings were presented as percentages. Additionally, the results for each aspect of the questionnaire were evaluated in light of existing recommendations.
Results
The survey response rate was 71% (25/35). Of the responding nephrologists, 76% identified as women, and 52% had been in practice between 10 and 19 years. Regarding multispecialty care, 36% reported having a full team, 40% had some team elements, and 24% had no team. Individualization of patient care was the most common practice, as opposed to a conventional or standardized approach. This preference for individualization extended to offering pre-natal genetic counselling, antenatal kidney biopsy and antibiotic prophylaxis, and post-partum ACE inhibitor re-initiation.
Conclusion
Our study is the first to assess the practice patterns and policies of Canadian nephrologists caring for pregnant people with CKD. We found important variations in obstetric nephrology care, and that the majority of programs did not have a full multispecialty team. These results emphasize an opportunity to improve care through the creation of formal multidisciplinary teams and the consistent adoption of evidence-based policies.