The crucial role of the nephrologist in the management of pregnancy in women with adult autosomal dominant polycystic kidney disease

Francesca Tunesi, Liliana Italia De Rosa, Martina Catania, Marta Vespa, Kristiana Kola, Giuseppe Vezzoli, Donatella Spotti, Micaela Petrone, Marco Simonini, Chiara Livia Lanzani, Maria Teresa Sciarrone Aliprandi
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Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is a genetic kidney disease characterized by gradual kidney enlargement and progressive renal function loss. Pregnancy is a significant risk factor for adverse maternal and fetal outcomes in chronic kidney disease (CKD), regardless of the nephropathy. Women with ADPKD often face concerns about worsening their renal condition and passing the disease on to their offspring. Recent studies show better outcomes due to improved pregnancy surveillance and prior counseling. Risk factors for poor fetal and maternal outcomes include advanced maternal age, pre-existing hypertension, urinary infections, proteinuria, and renal failure. Collaboration between nephrologists and gynecologists is essential for addressing clinically significant concerns in pregnant women with ADPKD. Nephrologists should play an active role in assisting and supporting pregnant ADPKD patients as part of a multidisciplinary team.
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肾科医生在成人常染色体显性多囊肾病妇女妊娠管理中的关键作用
常染色体显性多囊肾病(ADPKD)是一种以肾脏逐渐增大和进行性肾功能丧失为特征的遗传性肾脏疾病。妊娠是慢性肾脏疾病(CKD)不良母婴结局的重要危险因素,无论肾病如何。患有ADPKD的女性经常面临着肾脏状况恶化和将疾病传给后代的担忧。最近的研究表明,由于改善了妊娠监测和事先咨询,结果会更好。不良胎儿和产妇结局的危险因素包括高龄产妇、既往高血压、尿路感染、蛋白尿和肾衰竭。肾病学家和妇科医生之间的合作对于解决妊娠ADPKD患者的临床重大问题至关重要。作为一个多学科团队的一部分,肾病学家应该在帮助和支持妊娠ADPKD患者方面发挥积极作用。
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