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Informed Consent Living Donor Research Living Donor Risks

Pregnancy Post-Donation Includes Risk

Per a study from March 2016:

 

“A concern for donation-related risk was recently confirmed in an 11-year cohort study of 85 female donors and 510 healthy non-donors who were carefully matched on baseline risk factors. Donors were 2.4 times more likely to be diagnosed with gestational hypertension or preeclampsia compared with healthy non-donors.”

The confirmation above refers to prior studies that have also come to this same conclusion. Search the blog for other pregnancy related posts.

 

 

Sontrop, J., & Garg, A. (2016). Considerations for Living Kidney Donation Among Women of Childbearing Age: Evidence from Recent Studies Current Transplantation Reports, 3 (1), 10-14 DOI: 10.1007/s40472-016-0082-0

Categories
Living Donor Research Living Donor Risks Living Kidney Donor

Mild Kidney Disease Tied to Pregnancy Risk

A comparison of 504 women with various stages of chronic kidney disease with 836 of a well-matched cohort revealed:

in women with stage 1 CKD, the rate of caesarean section was 8.4% vs 70.1% for stage 2, 78.4% for stage 3, and 70.0% for stages 4 to 5 (P < .001).

Preterm delivery rate was 23.5% for stage 1 vs 50.6% for stage 2, 78.4% for stage 3, and 88.9% for stages 4 to 5 (P < .001).

NICU (neonatal intensive care unit) rates by stage were 10.3%, 27.6%, 44.4%, and 70.0% (P < .001).

[small size at birth] SGA (<10%) by stage was 13.3%, 17.9%, 18.9%, and 50.0% (P = .023).

General combined outcome ranged from 34.1% to 90.0% (P < .001), and severe combined outcome from 21.4% 80.0% (P < .001).

New-onset maternal hypertension ranged from 7.9% in stage 1 to 50.0% in stages 4 to 5 (P < .001).

New-onset or doubling of proteinuria was 20.5% in stage 1 and 70.0% in stages 4 to 5 (P < .001).

 

**Just a reminder: Stage 1 chronic kidney disease is GFR < 80 while Stage 3 is GFR < 60. Many living kidney donors find themselves in Stage 3 only a few years post-donation.**

 
Piccoli GB, Cabiddu G, Attini R, Vigotti FN, Maxia S, Lepori N, Tuveri M, Massidda M, Marchi C, Mura S, Coscia A, Biolcati M, Gaglioti P, Nichelatti M, Pibiri L, Chessa G, Pani A, & Todros T (2015). Risk of Adverse Pregnancy Outcomes in Women with CKD. Journal of the American Society of Nephrology : JASN PMID: 25766536

Categories
Living Donor Research Living Donor Risks Living Kidney Donor

Living Kidney Donors Face Higher Risk of Pre-Eclampsia During Pregnancy

A new study says that women who have donated a kidney are at higher risk of developing gestational hypertension or a potentially dangerous condition called pre-eclampsia during pregnancies that follow the donation.

Women who have donated a kidney face an 11 per cent risk of developing one of these conditions; for women who have both kidneys, it’s a five per cent chance.

Pre-eclampsia (the precursor to full-blown eclampsia) is a marked by a trio of classic symptoms — fluid retention, headaches and high blood pressure. While it can be fatal if untreated, ending the pregnancy by inducing delivery or performing a caesarean section will cure the condition.

 

Read more: http://www.ices.on.ca/Publications/Journal-Articles/2014/January/Gestational-hypertension-and-preeclampsia-in-living-kidney-donors