title: [Influences of pregnancy on the natural course of chronic glomerulonephritis with impaired renal function].
abstract: In an attempt to clarify the influence of pregnancy on the natural course of the chronic glomerulonephritis with impaired renal function (glomerular filtration rate: GFR less than or equal to 70 ml/min), the courses of 14 pregnancies occurring in 10 patients (seven with IgA nephropathy, one with membranoproliferative glomerulonephritis, one with membranous nephropathy and one with hereditary nephropathy) were studied. In 8 patients GFR measured before pregnancies ranged from 46 to 70 ml/min and in the other two creatinine clearance estimated in the first trimester of pregnancies was 62 and 49 ml/min, respectively. The pregnancies resulted in 10 live births, one spontaneous abortion, one artificial abortion and 2 neonatal deaths. In 2 out of 10 live births fetal weight was less than 2500 g. In 3 of 11 pregnancies there was neither increase in urinary protein nor elevation of blood pressure during pregnancies, while seven (64%) had increased proteinuria during the third trimester, and 4 of them were also complicated with hypertension. In 6 of 10 patients, there was no decrease in GFR during pregnancies. In three patients GFR was decreased from 70 to 36 ml/min, 70 to 58 ml/min and 62 to 48 ml/min, respectively. However, these reductions were considered to go with the natural course of respective patients because the reduction slopes were almost the same or rather mild in comparison with those estimated before or after pregnancies. The other patient also had a transient increase in serum creatinine level during two pregnancies, but the reciprocals of serum creatinine concentration before and after the pregnanciesdeclined linearly with time. These data suggest that pregnancy might have little influence on the natural course of the chronic glomerulonephritis even if complicated with renal functional impairment defined as GFR of 70 ml/min or less.
authors.affiliation: First Department of Internal Medicine, School of Medicine, Kanazawa University, Ishikawa, Japan.
authors.forename: S
authors.initials: S
authors.lastname: Takeda
authors.forename: H
authors.initials: H
authors.lastname: Kida
authors.forename: K
authors.initials: K
authors.lastname: Takasawa
authors.forename: K
authors.initials: K
authors.lastname: Ikeda
authors.forename: M
authors.initials: M
authors.lastname: Yoshimura
authors.forename: H
authors.initials: H
authors.lastname: Yokoyama
authors.forename: N
authors.initials: N
authors.lastname: Tomosugi
authors.forename: K
authors.initials: K
authors.lastname: Kobayashi
mesh_terms: D000293:Adolescent; D000328:Adult; D001794:Blood Pressure; D002908:Chronic Disease; D005260:Female; D005919:Glomerular Filtration Rate; D005921:Glomerulonephritis / Q000188:drug therapy / Q000473:pathology / Q000503:physiopathology*; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology*; D011239:Prednisolone / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*
chemical_list: D011239:Prednisolone