Kidney international reports · 2025
Kidney Replacement Therapy Within 12 Months of Childbirth in Australia.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Jahan Sadia, Davies Christopher, Chen Yu-Tyan, Sullivan Elizabeth, Jesudason Shilpanjali, Hewawasam Erandi
Аннотация
INTRODUCTION: Pregnancy may unmask or worsen kidney disease, in some cases leading to postnatal kidney failure. Outcomes in these women remain poorly defined.
METHODS: Using linked perinatal (1991-2013), hospital and Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) (1970-2016) records from 4 Australian jurisdictions, we explored characteristics and outcomes among women who commenced kidney replacement therapy (KRT) within 12 months postchildbirth.
RESULTS: Among 761 women who commenced KRT postchildbirth (N = 1196 babies), 44 started KRT within 12 months postchildbirth (n = 48 babies). Of these, 38 women began hemodialysis (HD), 4 began peritoneal dialysis (PD), and 2 received preemptive transplants. Median maternal age at childbirth was 29 years. The median time from childbirth to KRT initiation was 142 (interquartile range [IQR] 17-216) days, with one-third starting within 42 days postpartum. Among the HD group, 9 of 38 women (23.7%) transitioned to home dialysis within the first year. One-third of women died during follow-up (median: 13.7 years), with a median age at death of 31 (IQR: 28.5-36.1) years. Women who commenced HD died younger and sooner (median: 3.4 years postchildbirth, IQR: 2.8-7.1 years) than those who started on PD. Nearly 90% of babies were liveborn. Median gestational age was 34 (IQR: 31-37) weeks and birthweight was 2120 g (IQR: 1690-3090 g). Composite adverse pregnancy outcomes (≥ 1 of preterm birth, low birthweight, or hypertensive disorders) occurred in 75% of pregnancies.
CONCLUSION: Women commencing KRT within 12 months postchildbirth represents a high-risk group with complex medical needs. Maternal death during early childhood years is an underrecognized phenomenon and warrants further research.
METHODS: Using linked perinatal (1991-2013), hospital and Australia and New Zealand Dialysis and Transplant Registry (ANZDATA) (1970-2016) records from 4 Australian jurisdictions, we explored characteristics and outcomes among women who commenced kidney replacement therapy (KRT) within 12 months postchildbirth.
RESULTS: Among 761 women who commenced KRT postchildbirth (N = 1196 babies), 44 started KRT within 12 months postchildbirth (n = 48 babies). Of these, 38 women began hemodialysis (HD), 4 began peritoneal dialysis (PD), and 2 received preemptive transplants. Median maternal age at childbirth was 29 years. The median time from childbirth to KRT initiation was 142 (interquartile range [IQR] 17-216) days, with one-third starting within 42 days postpartum. Among the HD group, 9 of 38 women (23.7%) transitioned to home dialysis within the first year. One-third of women died during follow-up (median: 13.7 years), with a median age at death of 31 (IQR: 28.5-36.1) years. Women who commenced HD died younger and sooner (median: 3.4 years postchildbirth, IQR: 2.8-7.1 years) than those who started on PD. Nearly 90% of babies were liveborn. Median gestational age was 34 (IQR: 31-37) weeks and birthweight was 2120 g (IQR: 1690-3090 g). Composite adverse pregnancy outcomes (≥ 1 of preterm birth, low birthweight, or hypertensive disorders) occurred in 75% of pregnancies.
CONCLUSION: Women commencing KRT within 12 months postchildbirth represents a high-risk group with complex medical needs. Maternal death during early childhood years is an underrecognized phenomenon and warrants further research.