PMID: 25774590Mar 17, 2015Paper

Pregnancy, CKD and solitary kidney: kidney donation between clinical logic and taboos

Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Giorgina Piccoli

Abstract

On the occasion of the Congress of the American Society of Nephrology, the yearly issue of the NEJM introduces a selection of articles of interest for Nephrology, drawing attention to the incidence of hypertensive disorders of pregnancy in kidney donors. The article reconsiders this issue five years after two studies that described an increase in risk for adverse pregnancy outcomes after kidney donation. It disproves a previous assumption of "non-interference" between kidney donation and pregnancy outcomes. Meanwhile,CKD has been recognized as a risk factor for pregnancy, regardless of the presence of reduced renal function, hypertension and proteinuria, although these factors modulate the risk. In the discussion, the authors help to dispel the taboos that donor women are substantially different from women born with a solitary kidney or were so as an effect of a disease. Beside the issue of transplantation,the study indicates that we have to pay attention to all patients with CKD in pregnancy, giving us a very interesting clue for counselling. The risk of complications is greater in the donor population compared to a "low risk" population, but it is roughly equal to that of the general population, if the latter is not subject t...Continue Reading

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