{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T13:53:42Z","timestamp":1791986022032,"version":"4.4.0"},"reference-count":47,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T00:00:00Z","timestamp":1772150400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pregnancy"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Chronic kidney disease (CKD) can significantly affect pregnancy management and outcomes. Although up to 40% of adults with renal disease have an identifiable genetic cause, most pregnant patients with CKD do not undergo genetic testing, hindering tailored management during and after pregnancy. We assessed which pregnant patients with CKD were more likely to be referred for and undergo genetic counseling and testing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study design<\/jats:title>\n                    <jats:p>This was an Institutional Review Board\u2013approved retrospective cohort study of all patients who received prenatal care at Texas Children's Hospital between 2011 and 2024 and had a diagnosis of CKD or end\u2010stage renal disease (ESRD). Patients were identified using International Classification of Diseases, 10th Revision (ICD\u201010) codes in the electronic medical record. Demographic, clinical, and genetic data were abstracted and overlaid with social vulnerability index data (2022 release). Bivariate analyses were used to assess associations between demographic and clinical factors and genetic evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 103 pregnant patients had a diagnosis of CKD or ESRD. The median gestational age at entry to prenatal care was 8.6\u00a0weeks. While a majority of patients (64%) were referred to genetic counseling for any reason, only one in four (27%) referrals mentioned a renal indication. Even fewer patients (8%) underwent genetic testing before, during, or after pregnancy to determine the etiology of their chronic renal disease. Among demographic, socioeconomic, and clinical variables, only renal transplant and a family history of renal disease were associated with a recommendation for a renal genetic workup. Commercial insurance coverage was associated with completion of a renal genetic workup.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The majority of pregnant patients with renal disease did not undergo renal genetic testing before, during, or after pregnancy. Commercial insurance coverage was the only demographic, socioeconomic, or clinical factor significantly associated with completion of a genetic workup. While genetic evaluation for renal disease among pregnant patients is associated with insurance status, it is underutilized across demographic and socioeconomic sectors and should be considered for pregnant patients with renal disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/pmf2.70265","type":"journal-article","created":{"date-parts":[[2026,3,8]],"date-time":"2026-03-08T22:41:49Z","timestamp":1773009709000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Opportunities for renal genetic evaluation among pregnant patients with kidney disease"],"prefix":"10.1002","volume":"2","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5564-803X","authenticated-orcid":false,"given":"Likhita","family":"Nandigam","sequence":"first","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4511-3493","authenticated-orcid":false,"given":"Christian M.","family":"Parobek","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Molecular and Human Genetics Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taylor","family":"Moseley","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ansley E.","family":"Davis","sequence":"additional","affiliation":[{"name":"School of Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacie G.","family":"Denning","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2889-4558","authenticated-orcid":false,"given":"Mir","family":"Reza","sequence":"additional","affiliation":[{"name":"Department of Molecular and Human Genetics Baylor College of Medicine  Houston Texas USA"},{"name":"Department of Pediatrics Division of Pediatric Nephrology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai K.","family":"Saridey","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hennie A.","family":"Lombaard","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Baylor College of Medicine  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2023.10.018"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.27014"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1590\/2175\u20108239\u2010JBN\u20102020\u20100055"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.2014050459"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/1471\u20100528.17807"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2021.03.045"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000003256"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000005890"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2308577"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2022.03.019"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev\u2010med\u2010042921\u2010101813"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41588\u2010019\u20100407\u2010x"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1806891"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41436\u2010020\u20100772\u2010y"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.xkme.2022.100585"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000000000076"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1681\/ASN.0000000000000249"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2023.02.003"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1038\/kisup.2012.12"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2021.05.021"},{"key":"e_1_2_10_22_1","unstructured":"National Kidney Foundation.NKF KDOQI Clinical Practice Guidelines. 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