title: Pregnancy and progression of IgA nephropathy: results of an Italian multicenter study.
abstract: BACKGROUND
  Whether pregnancy impacts on the long-term outcome of immunoglobulin A (IgA) nephropathy is unknown. This study aims to compare the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function who did and did not become pregnant.
  
  
  METHODS
  Multicenter longitudinal cohort study.
  
  
  METHODS
  Women of childbearing age with biopsy-proven IgA nephropathy, serum creatinine level<or=1.2 mg/dL at diagnosis, and minimum follow-up of 5 years after biopsy recruited from 35 nephrology centers participating in a national collaborative study group of pregnancy and kidney disease sponsored by the Italian Society of Nephrology.
  
  
  METHODS
  Pregnancy, treated as a time-dependent variable; baseline proteinuria; hypertension; and kidney biopsy histologic characteristics.
  
  
  METHODS
  Rate of change in estimated creatinine clearance, change in proteinuria, and new-onset hypertension.
  
  
  RESULTS
  245 patients were enrolled. Of these, 223 women (136 and 87 in the pregnancy and nonpregnancy groups, respectively) had serum creatinine levels<or=1.2 mg/dL at diagnosis. Baseline data (including age, estimated creatinine clearance, prevalence of hypertension, and histologic grade of kidney damage) were similar between groups with the exception of proteinuria (protein excretion, 1.33 vs 0.95 g/d in the pregnancy vs nonpregnancy groups, respectively; P=0.03). Kidney function decreased 1.31 mL/min/y (95% CI, 0.99-1.63) during a median follow-up of 10 years (range, 5-31 years) and did not differ between groups. Baseline proteinuria predicted a faster decrease, but did not modify the effect of pregnancy. Pregnancy did not affect changes in proteinuria over time or risk of new-onset hypertension.
  
  
  CONCLUSIONS
  Unrecognized or unmeasured factors associated with the decision of becoming pregnant might have influenced results.
  
  
  CONCLUSIONS
  Pregnancy does not seem to affect the long-term outcome of kidney disease in women with IgA nephropathy and preserved kidney function.
authors.affiliation: Department of Nephrology, Dialysis and Transplantation, A. Manzoni Hospital, Lecco, Italy.
authors.forename: Monica
authors.initials: M
authors.lastname: Limardo
authors.forename: Enrico
authors.initials: E
authors.lastname: Imbasciati
authors.forename: Pietro
authors.initials: P
authors.lastname: Ravani
authors.forename: Maurizio
authors.initials: M
authors.lastname: Surian
authors.forename: Diletta
authors.initials: D
authors.lastname: Torres
authors.forename: Gina
authors.initials: G
authors.lastname: Gregorini
authors.forename: Riccardo
authors.initials: R
authors.lastname: Magistroni
authors.forename: Daniela
authors.initials: D
authors.lastname: Casellato
authors.forename: Linda
authors.initials: L
authors.lastname: Gammaro
authors.forename: Claudio
authors.initials: C
authors.lastname: Pozzi
mesh_terms: D000328:Adult; D018450:Disease Progression; D005260:Female; D005922:Glomerulonephritis, IGA / Q000503:physiopathology; D006801:Humans; D007558:Italy; D007668:Kidney / Q000503:physiopathology; D008137:Longitudinal Studies; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D011446:Prospective Studies