| 초록 |
Objectives: Previous studies reported that pregnant women with autosomal dominant polycystic kidney disease (ADPKD) had poor fetal outcomes and maternal complications. In ADPKD, total kidney volume is recognized as a prognostic biomarker for risk assessment. During pregnancy, the kidneys increase in size about 30%. However, there has been no study to evaluate the impact of pregnancy on the progression of total kidney volume among ADPKD patients.
Methods: This prospective multicenter cohort study enrolled 693 adult patients from October 2019 to June 2021 at 8 medical centers in Korea. Patients with more than 3 renal cysts in both kidneys were eligible to be recruited. The height-adjusted total kidney volume (htTKV) and Mayo Clinic imaging classification were measured by the ellipsoid equation. Three hundred thirty-seven male patients were excluded from the analysis.
Results: In total of 356 female patients, 280 patients (78.7%) had experienced pregnancy. The mean estimated glomerular filtration rate was 77.5 ± 31.8 ml/min/1.73m2 and the mean htTKV was 1316.3 ± 1013.0 ml/m. Patients who experienced pregnancy showed significantly larger htTKV compared with those without pregnancy (1367.2 ± 1057.6 vs. 1128.5 ± 806.4, respectively, p = 0.035). In patients who experienced pregnancy, age, body mass index, waist circumferences, and creatinine level was higher than patients without pregnancy. However, there was no significant relation between gravidity and Mayo imaging classification (OR = 0.692, 95% CI = 0.412–1.162, p = 0.164).
Conclusions: This study indicated that pregnancy might influence on the progression of htTKV in ADPKD patients. However, it did not affect the prognosis of the kidney. |