Does pregnancy alter the rate of progression of diabetic nephropathy?
The effect of gestation on the rate of decline in renal function was studied in 11 pregnancies complicated by diabetic nephropathy. For each pregnancy, serum creatinine levels were available within 4 years before pregnancy, during pregnancy, and within 4 years after delivery. Although all of these patients were hypertensive and had increased proteinuria during pregnancy, the mean serum creatinine just prior to conception (1.3 +/- 0.5 mg/dl) and the last follow-up value (1.2 +/- 0.3 mg/dl) were not significantly different. When the inverse of serum creatinine (1/Scr) was used to estimate creatinine clearance, the renal function was either improved or remained stable in the majority of the pregnancies (7 of 11). The observed decline in renal function through the end of follow-up appeared to be consistent with the expected natural course of diabetic nephropathy in the absence of pregnancy. Furthermore, the slope for inverse serum creatinine before and after pregnancy was not significantly different. In conclusion, pregnancy in patients with mild to moderate diabetic nephropathy does not seem to accelerate the rate of decline in renal function.
Reece
E A
EA
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, Connecticut 06510.
Winn
H N
HN
Hayslett
J P
JP
Coulehan
J
J
Wan
M
M
Hobbins
J C
JC
D000328:Adult; D001794:Blood Pressure; D003404:Creatinine / Q000097:blood; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000378:metabolism; D003928:Diabetic Nephropathies / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007668:Kidney / Q000503:physiopathology; D011247:Pregnancy; D011254:Pregnancy in Diabetics / Q000378:metabolism
D003404:Creatinine