{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,11]],"date-time":"2025-11-11T13:08:44Z","timestamp":1762866524946},"reference-count":32,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2015,2,24]],"date-time":"2015-02-24T00:00:00Z","timestamp":1424736000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nephrology"],"published-print":{"date-parts":[[2015,3]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The correlation between advanced or proteinuric chronic kidney disease (CKD<\/jats:styled-content>) and adverse pregnancy outcomes is intuitive, although how early CKD<\/jats:styled-content> affects pregnancy remains unknown. Glomerular hyperfiltration is a physiological response to pregnancy, correlated with outcomes in hypertension or collagen diseases. The aim of the study was to correlate first trimester hyperfiltration with pregnancy outcomes in stage 1 CKD<\/jats:styled-content> patients.<\/jats:p><\/jats:sec>Methods<\/jats:title>A historical prospective study was conducted on the database of our Unit, gathering all pregnant CKD<\/jats:styled-content> patients referred since 1 J<\/jats:styled-content>anuary 2000. From 383 pregnancies referred in 2000\u20132013, 75 patients were selected (stage 1 CKD<\/jats:styled-content>, referred within the 14th gestational week, singleton deliveries, absence of diabetes, hypertension or nephrotic proteinuria at referral, body mass index [BMI<\/jats:styled-content>]\u2009<\u200930); 267 \u2018low\u2010risk\u2019 pregnancies, followed in the same setting, served as controls. Glomerular filtration rate (GFR<\/jats:styled-content>) was assessed by C<\/jats:styled-content>hronic K<\/jats:styled-content>idney D<\/jats:styled-content>isease E<\/jats:styled-content>pidemiology C<\/jats:styled-content>ollaboration (CKD<\/jats:styled-content>\u2010EPI<\/jats:styled-content>) and dichotomized at 120\u2009mL\/min. The odds for C<\/jats:styled-content>aesarean section, prematurity, need for N<\/jats:styled-content>eonatal I<\/jats:styled-content>ntensive C<\/jats:styled-content>are U<\/jats:styled-content>nit (NICU<\/jats:styled-content>) were assessed by univariate analysis and logistic regression.<\/jats:p><\/jats:sec>Results<\/jats:title>Risk for adverse pregnancy outcomes was not affected by hyperfiltration (univariate OR GFR<\/jats:styled-content> \u2265 120\u2009mL\/min: Caesarean section 1.30 (0.46\u20133.65); preterm delivery: 0.84 (0.25\u20132.80)). In contrast, even in these cases with normal kidney function, stage 1 CKD<\/jats:styled-content> was associated with prematurity (17.3% vs 4.9% P<\/jats:italic>\u2009=\u20090.001), lower birth weight (3027\u2009\u00b1\u2009586 versus 3268\u2009\u00b1\u2009500 P<\/jats:italic>\u2009<\u20090.001) need for NICU<\/jats:styled-content> (12% vs 1.1% P<\/jats:italic>\u2009<\u20090.001). In the multivariate analysis, the risks were significantly increased by proteinuria and maternal age but not by GFR<\/jats:styled-content>.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>In pregnant Stage 1 CKD<\/jats:styled-content> patients, hyperfiltration was not associated with maternal\u2010foetal outcomes, thus suggesting a need to focus attention on qualitative factors, eventually enhanced by age, as vascular stiffness, endothelial damage or oxidative stress.<\/jats:p><\/jats:sec>","DOI":"10.1111\/nep.12372","type":"journal-article","created":{"date-parts":[[2014,12,4]],"date-time":"2014-12-04T01:09:20Z","timestamp":1417655360000},"page":"201-208","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Is renal hyperfiltration protective in chronic kidney disease\u2010stage 1 pregnancies? A step forward unravelling the mystery of the effect of stage 1 chronic kidney disease on pregnancy outcomes"],"prefix":"10.1111","volume":"20","author":[{"given":"Giorgina Barbara","family":"Piccoli","sequence":"first","affiliation":[{"name":"SS Nefrologia Department of Clinical and Biological Sciences ASOU San Luigi Gonzaga University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rossella","family":"Attini","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica Neve","family":"Vigotti","sequence":"additional","affiliation":[{"name":"SS Nefrologia Department of Clinical and Biological Sciences ASOU San Luigi Gonzaga University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Silvia","family":"Parisi","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federica","family":"Fassio","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arianna","family":"Pagano","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marilisa","family":"Biolcati","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Domenica","family":"Giuffrida","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alessandro","family":"Rolfo","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tullia","family":"Todros","sequence":"additional","affiliation":[{"name":"Materno\u2010Foetal Unit OIRM S Anna Department of Surgical Sciences University of Turin Turin Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2015,2,24]]},"reference":[{"key":"e_1_2_5_2_1","first-page":"S1","article-title":"KDOQI clinical practice guidelines for chronic kidney disease: Evaluation, classification and stratification","volume":"39","author":"National Kidney Foundation","year":"2002","journal-title":"Am. 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