title: [Perinatal complications in patients with chronic renal failure].
abstract: BACKGROUND
  Pregnant patients with chronic renal insufficiency (CRI) have a high risk of perinatal complications and deterioration of renal filtration (RF).
  
  
  OBJECTIVE
  To report perinatal complications and changes of RF according to disease severity.
  
  
  METHODS
  Cross-sectional study including 28 pregnant patients grouped into three categories of CRI according to initial creatinine (Cr): mild CRI < 1.5, moderate CRI 1.5-2.5 and severe CRI > 2.5 mg/dL. Pre-labor vs initial perinatal complications and changes in endogenous creatinine clearance (CrCI) were reported. Descriptive statistics and Student t-test were used for statistical analyses.
  
  
  RESULTS
  Mild CRI was found in 50%, moderate in 35.72% and severe in 14.28% of patients. Maternal complications were as follows. Mild CRI: Cesarean (35.72%), deterioration of RF (21.42%) and worsening of systemic arterial hypertension (SAH) (7.14%); moderate CRI: Cesarean (28.57%), deterioration of RF (28.57%) and worsening of SAH (14.28%); severe CRI: Cesarean (14.28%), deterioration of RF (14.28%) and anemia (14.28%). Fetal complications were as follows. Mild CRI: prematurity (25%), fetal growth restriction (FGR) (7.14%) and fetal death (7.14%), moderate CRI: prematurity (21.42%), FGR (3.57%) and no reassuring fetal status (NRFS) (3.57%), severe CRI: prematurity (14.28%), NRFS (7.14%) and respiratory insufficiency (7.14%). Mild CRI showed a reduction of endogenous CrCI (p = 0.03) not shown in other categories.
  
  
  CONCLUSIONS
  An elevated frequency of complications was found, with the most serious occurring in patients with severe CRI. Deterioration of RF was found in patients with mild CRI.
authors.affiliation: Unidad Médica de Alta Especialidad, Hospital de Ginecología y Obstetricia número 3, Centro Médico Nacional La Raza, Instituto Mexicano del Seguro Social, México, DF. juangustavovazquez@hotmail.com
authors.forename: Juan Gustavo
authors.initials: JG
authors.lastname: Vázquez-Rodríguez
authors.forename: Marisol
authors.initials: M
authors.lastname: Rivera-Hernández
mesh_terms: D000328:Adult; D002585:Cesarean Section / Q000706:statistics & numerical data; D015897:Comorbidity; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005260:Female; D005313:Fetal Death / Q000453:epidemiology; D005315:Fetal Diseases / Q000453:epidemiology; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D007231:Infant, Newborn; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology* / Q000628:therapy; D008800:Mexico / Q000453:epidemiology; D007752:Obstetric Labor, Premature / Q000453:epidemiology; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology*; D011256:Pregnancy Outcome; D011644:Puerperal Disorders / Q000453:epidemiology; D006435:Renal Dialysis; D012720:Severity of Illness Index; D055815:Young Adult
chemical_list: D003404:Creatinine