Pregnancy Outcomes in Patients with Glomerular Disease Attending a Single Academic Center in North Carolina

2017 ◽  
Vol 45 (5) ◽  
pp. 442-451 ◽  
Author(s):  
Michelle M. O'Shaughnessy ◽  
Meghan A. Jobson ◽  
Katy Sims ◽  
Abigail L. Liberty ◽  
Patrick H. Nachman ◽  
...  
Keyword(s):  
North Carolina ◽  
Kidney Function ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Obstetric Care ◽  
Glomerular Disease ◽  
Primary Study ◽  
Glomerular Diseases ◽  
Disease Subtypes ◽  
Primary Glomerular Disease

Background: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. Methods: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database. The primary study outcome was perinatal death (stillbirth at >20 weeks or neonatal death). Secondary outcomes included premature birth (<37 weeks), birth weight, preeclampsia, and kidney function changes (postpartum vs. baseline). Demographics, clinical characteristics, and outcomes were compared across glomerular disease subtypes. Results: Among 48 pregnancies in 43 women (IgA nephropathy n = 17, focal segmental glomerulosclerosis [FSGS] n = 16, membranous nephropathy n = 6, minimal change disease n = 4), 13% of pregnancies resulted in perinatal death and 48% of babies were born prematurely. From a maternal perspective, 33% of pregnancies were complicated by preeclampsia, 39% by a doubling of urinary protein, and 27% by a ≥50% increase in serum creatinine. Outcome differences across glomerular disease subtypes were not statistically significant, although decline in kidney function appeared most frequent in FSGS. Conclusion: Adverse pregnancy outcomes are frequently observed in women with glomerular disease. The independent influence of glomerular disease subtype on outcomes requires further study. More widespread reporting and analysis of pregnancy outcomes in women with glomerular disease are urgently needed.

Infection-related and renal-limited glomerulonephritis

2019 ◽  
pp. 467-494
Author(s):  
Richard J Glassock ◽  
Lee Hebert ◽  
Gabriella Moroni ◽  
Claudio Ponticelli
Keyword(s):  
Disease Burden ◽  
Cellular Proliferation ◽  
Renal Involvement ◽  
Glomerular Disease ◽  
Glomerular Diseases ◽  
Endemic Diseases ◽  
Primary Glomerular Disease ◽  
Wide Swath

This chapter covers the infection-related glomerulonephritides, which encompass a wide swath of epidemic and endemic diseases. Bacteria, fungi, protozoa, nematodes, helminths and viruses all contribute to the glomerular disease burden. Most of these have numerous and varied extra-renal manifestations and are commonly classified as secondary glomerular diseases. However, a few have mainly or exclusively renal involvement and can be classified within the rubric of primary glomerular disease. This group of glomerular diseases is characterized by intraglomerular inflammation and cellular proliferation resulting from immunological events triggered by a variety of organisms. This chapter discusses the prototypical renal-limited forms of infection-related glomerulonephritis.

Primary glomerular disease

Medicine ◽  
2011 ◽  
Vol 39 (8) ◽  
pp. 456-463
Author(s):  
Peter Mathieson
Keyword(s):  
Glomerular Disease ◽  
Primary Glomerular Disease

scholarly journals Eclampsia: Feto-Maternal Outcomes in A Tertiary Care Centre in Eastern Nepal

2016 ◽  
Vol 54 (201) ◽  
pp. 24-28 ◽  
Author(s):  
Sita Ghimire
Keyword(s):  
Perinatal Death ◽  
Early Recognition ◽  
Tertiary Care ◽  
Obstetric Care ◽  
Maternal Outcomes ◽  
Tertiary Care Centre ◽  
Cross Sectional ◽  
Medical College ◽  
Maternal Morbidity And Mortality ◽  
Common Causes

Introduction: Eclampsia is a preventable and treatable cause of maternal morbidity and mortality with poor feto-maternal outcome in developing countries. Despite development in the level of health education expertise in human resources and institutional obstetric care in our country, the delay in early recognition of the problem, transportation to proper health facility and getting proper expert care are major hurdles to reduce complications. Therefore we decided to study feto-maternal outcomes in our setting.Methods: A retrospective cross-sectional hospital based study carried out in Nobel Medical College, Biratnagar, from 17th June 2014 to 16th June 2015. Details and data obtained from Medical Record Section were analysed. All patients with eclampsia were included and fetomaternal outcomes measured in terms of complications. Simple descriptive statistical method was applied for analysis.Results: Among 8,066 deliveries, 112 had eclampsia with incidence of 13.8/1000 deliveries. Majority (41%) were of <19 years of age. Above 90% were unbooked. Aoubt 63.4% were primiparas and 83% had antepartum eclampsia. Eclamptic fits were more common (41.6%) in 37-40 weeks period of gestation. Fits to delivery interval was more than six hours in 89.1% women and 69.3% women underwent caesarean delivery. About 18.9% women developed eclampsia related complications. Common causes of maternal deaths (5.36%) were pulmonary edema, aspiration pneumonia, cerebrovascular accidents and HELLP syndrome. Perinatal death was nine percent.Conclusions: Although the obstetric care facilities are improving with time, the feto-maternal outcomes are still poor in our country. Therefore early recognition and proper management are vital to tackle this challenge. Keywords: eclampsia; fetomaternal outcomes; retrospective analysis. | PubMed

scholarly journals Joint Modeling of Singleton Preterm Birth and Perinatal Death Using Birth Registry Cohort Data in Northern Tanzania

2021 ◽  
Vol 9 ◽  
Author(s):  
Innocent B. Mboya ◽  
Michael J. Mahande ◽  
Joseph Obure ◽  
Henry G. Mwambi
Keyword(s):  
Preterm Birth ◽  
Pregnancy Outcomes ◽  
Perinatal Death ◽  
Substantial Reduction ◽  
Adverse Pregnancy Outcomes ◽  
Birth Registry ◽  
Cohort Data ◽  
Northern Tanzania ◽  
Management Of Complications ◽  
Adverse Pregnancy

Understanding independent and joint predictors of adverse pregnancy outcomes is essential to inform interventions toward achieving sustainable development goals. We aimed to determine the joint predictors of preterm birth and perinatal death among singleton births in northern Tanzania based on cohort data from the Kilimanjaro Christian Medical Center (KCMC) zonal referral hospital birth registry between 2000 and 2017. We determined the joint predictors of preterm birth and perinatal death using the random-effects models to account for the correlation between these outcomes. The joint predictors of higher preterm birth and perinatal death risk were inadequate (&lt;4) antenatal care (ANC) visits, referred for delivery, experiencing pre-eclampsia/eclampsia, postpartum hemorrhage, low birth weight, abruption placenta, and breech presentation. Younger maternal age (15–24 years), premature rupture of membranes, placenta previa, and male children had higher odds of preterm birth but a lessened likelihood of perinatal death. These findings suggest ANC is a critical entry point for delivering the recommended interventions to pregnant women, especially those at high risk of experiencing adverse pregnancy outcomes. Improved management of complications during pregnancy and childbirth and the postnatal period may eventually lead to a substantial reduction of adverse perinatal outcomes and improving maternal and child health.

Primary glomerular disease

2013 ◽  
pp. 86-86
Author(s):  
David Oliveira ◽  
Debasish Banerjee ◽  
Joyce Popoola ◽  
Iain MacPhee ◽  
Seema Shrivastava ◽  
...  
Keyword(s):  
Glomerular Disease ◽  
Primary Glomerular Disease

scholarly journals Inactivation of mediator complex protein 22 in podocytes results in intracellular vacuole formation, podocyte loss and premature death

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Patricia Q. Rodriguez ◽  
David Unnersjö-Jess ◽  
Sonia S. Zambrano ◽  
Jing Guo ◽  
Katja Möller-Hackbarth ◽  
...  
Keyword(s):  
Critical Role ◽  
Kidney Tissue ◽  
Premature Death ◽  
Glomerular Disease ◽  
Mediator Complex ◽  
Glomerular Diseases ◽  
Vacuole Formation ◽  
Podocyte Loss ◽  
Complex Protein ◽  
Intracellular Vacuole

AbstractPodocytes are critical for the maintenance of kidney ultrafiltration barrier and play a key role in the progression of glomerular diseases. Although mediator complex proteins have been shown to be important for many physiological and pathological processes, their role in kidney tissue has not been studied. In this study, we identified a mediator complex protein 22 (Med22) as a renal podocyte cell-enriched molecule. Podocyte-specific Med22 knockout mouse showed that Med22 was not needed for normal podocyte maturation. However, it was critical for the maintenance of podocyte health as the mice developed progressive glomerular disease and died due to renal failure. Detailed morphological analyses showed that Med22-deficiency in podocytes resulted in intracellular vacuole formation followed by podocyte loss. Moreover, Med22-deficiency in younger mice promoted the progression of glomerular disease, suggesting Med22-mediated processes may have a role in the development of glomerulopathies. This study shows for the first time that mediator complex has a critical role in kidney physiology.

The glomerulus and the concept of glomerulonephritis

2015 ◽  
Author(s):  
Alexander Woywodt ◽  
Diana Chiu
Keyword(s):  
Filtration Rate ◽  
Hybrid Approach ◽  
Glomerular Disease ◽  
Multisystem Disease ◽  
Glomerular Diseases ◽  
Clinical Syndromes ◽  
Different Types ◽  
Key Features ◽  
The 1960S

The key features of glomerular diseases—haematuria, proteinuria, loss of glomerular filtration rate, and hypertension—were recognized in the nineteenth century, and some earlier, but Richard Bright is usually given credit for synthesizing the concepts of renal disease, and glomerulonephritis came under the heading of Bright’s disease for almost a century. Separation into different types was based on first clinical syndromes, but in the early twentieth century, pathological description was improving and with the introduction of percutaneous renal biopsies in the 1950s, in the 1960s histopathological definitions assumed the ascendancy. A unifying classification of glomerular disease remains work in progress. Current classifications are pathologically based but increasingly include the results of other investigations (including genotype and a variety of immunological and other tests). This chapter follows this pragmatic, hybrid approach, categorizing glomerular disease by pattern on renal biopsy except where aetiological factors are clearly identified (e.g. HIV nephropathy), or associated multisystem disease is defined (e.g. lupus nephritis), or the immunopathogenesis is well characterized (e.g. antiglomerular basement membrane disease).

scholarly journals A Case of Essential Thrombocythemia and IgA Nephropathy with Literature Review of the Concurrence

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Shoja Rahimian ◽  
Timothy Johnson ◽  
Ronald Herb
Keyword(s):  
Renal Function ◽  
Literature Review ◽  
Essential Thrombocythemia ◽  
Myeloproliferative Neoplasms ◽  
Immunoglobulin A ◽  
Glomerular Disease ◽  
Common Finding ◽  
Glomerular Diseases ◽  
Pathological Review ◽  
History Of

Myeloproliferative neoplasms such as essential thrombocythemia (ET) have been associated with glomerular disease on rare instances. A case of ET associated with immunoglobulin A nephropathy (IgAN) is described in a 57-year-old man with a history of hypertension. Progressively worsening renal function was noted in the patient along with unexplained mild thrombocytosis. Pathological review of renal biopsy identified IgAN concurrently with newly diagnosed JAK2-mutated ET. The patient was started on aspirin therapy and closely monitored for his renal function. A literature review of the association of ET and renal disease revealed nine cases of ET associated with IgAN, focal segmental glomerulosclerosis, and fibrillary glomerulonephritis. Comparison of the pathological features of the renal biopsies within the cases noted mesangial proliferation as a common finding, which has been described to be potentiated by platelet-derived growth factor (PDGF). This commonality may represent a link between ET and glomerular disease which deserves further attention in future cases. Improved management of such cases depends on the recognition of the combined occurrence of ET and glomerular diseases and uncovering the shared pathogenesis between platelets and glomeruli.

Kidney Function and Protein Excretion in Relation to Pathomorphology of Glomerular Diseases

2015 ◽  
pp. 128-135 ◽  
Author(s):  
I. J�ckle ◽  
W. G�nther ◽  
H. von Gise ◽  
J. M. Alt ◽  
A. Bohle ◽  
...  
Keyword(s):  
Kidney Function ◽  
Glomerular Diseases ◽  
Protein Excretion
Sign in / Sign up

Export Citation Format

Share Document