Pregnancy and progression of IgA nephropathy: Results of an Italian multicenter study

Monica Limardo, Enrico Imbasciati, Pietro Ravani, Maurizio Surian, Diletta Torres, Gina Gregorini, Riccardo Magistroni, Daniela Casellato, Linda Gammaro, Claudio Pozzi

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Whether pregnancy impacts on the long-term outcome of immunoglobulin A (IgA) nephropathy is unknown. This study aims to compare the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function who did and did not become pregnant. Study Design: Multicenter longitudinal cohort study. Setting & Participants: Women of childbearing age with biopsy-proven IgA nephropathy, serum creatinine level ≤1.2 mg/dL at diagnosis, and minimum follow-up of 5 years after biopsy recruited from 35 nephrology centers participating in a national collaborative study group of pregnancy and kidney disease sponsored by the Italian Society of Nephrology. Predictors: Pregnancy, treated as a time-dependent variable; baseline proteinuria; hypertension; and kidney biopsy histologic characteristics. Outcome & Measures: Rate of change in estimated creatinine clearance, change in proteinuria, and new-onset hypertension. Results: 245 patients were enrolled. Of these, 223 women (136 and 87 in the pregnancy and nonpregnancy groups, respectively) had serum creatinine levels ≤1.2 mg/dL at diagnosis. Baseline data (including age, estimated creatinine clearance, prevalence of hypertension, and histologic grade of kidney damage) were similar between groups with the exception of proteinuria (protein excretion, 1.33 vs 0.95 g/d in the pregnancy vs nonpregnancy groups, respectively; P = 0.03). Kidney function decreased 1.31 mL/min/y (95% CI, 0.99-1.63) during a median follow-up of 10 years (range, 5-31 years) and did not differ between groups. Baseline proteinuria predicted a faster decrease, but did not modify the effect of pregnancy. Pregnancy did not affect changes in proteinuria over time or risk of new-onset hypertension. Limitations: Unrecognized or unmeasured factors associated with the decision of becoming pregnant might have influenced results. Conclusions: Pregnancy does not seem to affect the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function.

Original languageEnglish
Pages (from-to)506-512
Number of pages7
JournalAmerican Journal of Kidney Diseases
Volume56
Issue number3
DOIs
Publication statusPublished - Sep 2010

Keywords

  • angiotensin-converting enzyme (ACE) inhibitors
  • chronic kidney disease
  • glomerulonephritis
  • Immunoglobulin A (IgA) nephropathy
  • pregnancy
  • proteinuria
  • renal disease progression

ASJC Scopus subject areas

  • Nephrology
  • Medicine(all)

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