Pregnancy outcome in women with chronic kidney disease: a prospective cohort study

To evaluate pregnancy outcome in women with chronic kidney disease (CKD) or proteinuria in early pregnancy with concomitant risk for preeclampsia (PE).

Thirty-six women with CKD (Cr > 100 micromol/L at booking or Cr > 125 micromol/L prepregnancy or proteinuria ≥ 500 mg/24 hours at booking) and 30 women with proteinuria (≥2+) and known clinical risk for PE were enrolled at 14(+0) to 21(+6) weeks. Pregnancy outcomes were assessed.

Women with mild CKD (prepregnancy Cr < 125 µmol/Cr > 100 µmol at booking; n = 22) had high rates of preeclampsia (40%), preterm delivery (<37 weeks' gestation; 54%), SGA infants (<10th adjusted centile; 64%)and perinatal death (5%). Women with moderate/severe CKD (prepregnancy creatinine > 125 µmol; n = 14) had poor perinatal outcomes: preterm delivery (86%) and perinatal death (14%). Women with proteinuria (≥2+) and concomitant risk of PE also had high rates of pre-eclampsia (60%), preterm delivery (40%), and SGA infants (27%).

Pregnancy complications for women with CKD remain high. Women with risk factors for PE with proteinuria (≥2+) at booking are also high-risk.