PREGNANCY MANAGEMENT IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 4
https://doi.org/10.24884/1561-6274-2019-23-2-109-116
Abstract
Pregnancy in patients with an advanced stage of chronic kidney disease (CKD) remains a rather rare situation to date. This observation demonstrates our own experience of successfully management of pregnancy in a patient with chronic kidney disease stage 4. A special feature of this observation is an unclear diagnosis that led to CKD. Based on a combination of advanced CKD in a young patient with no kidney history, no changes in urine tests, increased blood pressure, hyperuricemia, and small cysts of both kidneys, a diagnosis of autosomal dominant tubulo-interstitial kidney disease was suggested, despite the lack of family history of renal disease. Since the kidney disease was first identified during pregnancy, the main areas of care were the correction of complications (anemia, calcium-phosphorus disorders), caused by the advanced stage of CKD and the prevention of pre-eclampsia as one of the most frequent complications of pregnancy in this cohort of patients. In order to timely diagnose preeclampsia, the patient was regularly monitored for angiogenesis markers. Conducting pregnancy was carried out by an interdisciplinary team of specialists (nephrologists, obstetrician-gynecologists). Pregnancy ended with the birth of healthy baby. After childbirth renal failure progressed.
About the Authors
N. L. Kozlovskaya
Nephrology center for pregnant women with kidney disease, City Clinical Hospital n.a. A.K. Eramishancev, Moscow;
Peoples Friendship University of Russia, Moscow
Russian Federation
Associate professor, MD, PhD, I.M. Sechenov First Moscow State Medical University, Department of Internal Medicine and Occupational Medicine
Russian Federation
Associate professor, MD, PhD, I.M. Sechenov First Moscow State Medical University, Department of Internal Medicine and Occupational Medicine
Y. V. Korotchaeva
Nephrology center for pregnant women with kidney disease, City Clinical Hospital n.a. A.K. Eramishancev, Moscow;
I.M. Sechenov First Moscow State Medical University (Sechenov Univercity), Moscow
Russian Federation
Russian Federation
Associate professor, MD, PhD, I.M. Sechenov First Moscow State Medical University, Department of Internal Medicine and Occupational Medicine
K. A. Demyanova
Nephrology center for pregnant women with kidney disease, City Clinical Hospital n.a. A.K. Eramishancev, Moscow;
Peoples Friendship University of Russia, Moscow
Russian Federation
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, nephrology center for pregnant women with kidney disease.
Department of Internal Medicine with the course of functional diagnostics and cardiology n.a.V.S.Moiseev, Peoples' Friendship University of Russia
M. M. Engibaryan
Maternity ward №1, City Clinical Hospital n.a. A.K. Eramishancev, Moscow
Russian Federation
MD, PhD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, Maternity ward №1.
Russian Federation
MD, PhD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, Maternity ward №1.
M. S. Mikulyak
Maternity ward №1, City Clinical Hospital n.a. A.K. Eramishancev, Moscow
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, Maternity ward №1.
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, Maternity ward №1.
A. V. Bespalova
Nephrology unit, City Clinical Hospital n.a. A.K. Eramishancev, Moscow,
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, nephrology department
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, nephrology department
T. V. Bondarenko
Nephrology unit, City Clinical Hospital n.a. A.K. Eramishancev, Moscow,
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, head of the nephrology department
Russian Federation
MD, State Budgetary Healthcare Institution “City Clinical Hospital n.a. A.K. Eramishancev” of the Healthcare Department of the Moscow city, head of the nephrology department
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Review
For citations:
Kozlovskaya N.L., Korotchaeva Y.V., Demyanova K.A., Engibaryan M.M., Mikulyak M.S., Bespalova A.V., Bondarenko T.V. PREGNANCY MANAGEMENT IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 4. Nephrology (Saint-Petersburg). 2019;23(2):109-116. (In Russ.) https://doi.org/10.24884/1561-6274-2019-23-2-109-116
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