Role of sFlt-1/PIGF ratio and uterine Doppler in pregnancies with chronic kidney disease suspected with Pre-eclampsia or HELLP syndrome.

Karge, Anne; Beckert, Lina; Moog, Philipp; Haller, Bernhard; Ortiz, Javier U; Lobmaier, Silvia M; Abel, Kathrin; Flechsenhar, Sarah; Kuschel, Bettina; Graupner, Oliver

doi:10.1016/j.preghy.2020.09.007

journal article

Title:: Role of sFlt-1/PIGF ratio and uterine Doppler in pregnancies with chronic kidney disease suspected with Pre-eclampsia or HELLP syndrome.
Document type:: Article; Journal Article
Author(s):: Karge, Anne; Beckert, Lina; Moog, Philipp; Haller, Bernhard; Ortiz, Javier U; Lobmaier, Silvia M; Abel, Kathrin; Flechsenhar, Sarah; Kuschel, Bettina; Graupner, Oliver
Abstract:: PURPOSE: Pregnancies of women with chronic kidney disease (CKD) are at higher risk of experiencing adverse perinatal (APO) and maternal outcome (AMO). Mean uterine artery pulsatility index (mUtA-PI) as well as the ratio of soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are helpful tools in diagnosing pre-eclampsia (PE) in women with CKD. The aim of the study was to evaluate the role of sFlt-1/PIGF ratio and mUtA-PI as predictors for APO, AMO, preterm delivery and decline of kidney function in CKD pregnancies. METHODS: A total of 28 CKD pregnancies with suspected PE/HELLP syndrome were retrospectively included, in whom both sFlt-1/PIGF and mUtA-PI were determined during the third trimester. APO was defined as fetal growth restriction, respiratory distress syndrome, intubation, admission to NICU, 5 min Apgar <7 and intracerebral hemorrhage. AMO was defined as the development of PE, HELLP syndrome or resistant hypertension. Decline of kidney function was defined as a 25% increase of creatinine level after delivery. RESULTS: Of all included women, eight (28.6%) developed a PE/HELLP syndrome. AMO (28.6%) and APO (32.1%) were frequently observed. ROC analyses revealed a predictive value for AMO and sFlt-1/PIGF or mUtA-PI. Neither sFlt-1/PIGF nor mUtA-PI could predict APO or decline of postnatal kidney function. mUtA-PI was a predictor for preterm delivery. CONCLUSION: Uterine Doppler and sFlt-1/PIGF are predictors of AMO in CKD pregnancies. Therefore, both markers might be helpful for an improved risk assessment. However, neither sFlt-1/PIGF nor mUtA-PI were able to predict a decline of postnatal kidney function or APO.
Journal title abbreviation:: Pregnancy Hypertens
Year:: 2020
Journal volume:: 22
Pages contribution:: 160-166
Fulltext / DOI:: doi:10.1016/j.preghy.2020.09.007
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/32992124
Print-ISSN:: 2210-7789
TUM Institution:: Frauenklinik und Poliklinik; Institut für Medizinische Statistik und Epidemiologie
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