AJKD:妊娠高血压疾病后急性肾损伤的风险

2021-09-10 MedSci原创 MedSci原创

先兆子痫是分娩后90天以上发生AKI的危险因素。该研究结果表明,将妊娠史作为急性肾病综合风险评估的一部分具有潜在意义,并表明伴有HDP病史的女性可能从肾功能监测中受益。

尽管研究表明妊娠期高血压疾病(HDP)与慢性肾病之间存在关系,但HDP后急性肾损伤(AKI)风险的数据十分有限。

近日,肾脏病学权威杂志Am J Kidney Dis上发表了一篇研究文章,该研究旨在评估HDP后发生AKI的风险。

该研究为基于人群的回顾性队列研究,参与者为加拿大安大略省年龄为14-50岁的孕妇,她们在2002年4月1日至2015年3月31日期间分娩。暴露因素为先兆子痫,妊娠高血压,或两者都没有。该研究的主要结局为分娩后90天以上发生接受透析(AKI-D)的AKI,主要次要结局是分娩后90天以上发生基于住院治疗的AKI。时间相关的Cox比例和特定原因的风险模型用于评估HDP和感兴趣的结局之间的关系。模型针对基线和随时间变化的协变量进行了调整。

该研究的队列纳入了1142656名女性和1826235次分娩事件,其中1.7%与妊娠高血压相关,4.4%与先兆子痫相关。平均随访6.7年后,共发生322次AKI-D(每10000人每年0.41次)和1598次基于诊断代码的AKI(每10000人每年2.04次)。调整后,先兆子痫和妊娠高血压均与AKI-D无关。先兆子痫与AKI相关(HR为1.22,95%CI为1.03-1.45),但妊娠期高血压与此无关。

由此可见,先兆子痫是分娩后90天以上发生AKI的危险因素。该研究结果表明,将妊娠史作为急性肾病综合风险评估的一部分具有潜在意义,并表明伴有HDP病史的女性可能从肾功能监测中受益。

原始出处:

Joshua Shapiro,et al.Risk of Acute Kidney Injury After Hypertensive Disorders of Pregnancy: A Population-Based Cohort Study.Am J Kidney Dis.2021.https://www.ajkd.org/article/S0272-6386(21)00832-5/fulltext

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    2021-11-24 花间结缡

    棒棒的!

    0

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  4. [GetPortalCommentsPageByObjectIdResponse(id=1073524, encodeId=5cf210e3524ac, content=棒棒的! , beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201112/663d2bea34a2473b8f98d8cc00479b37/2ef6cb0b5b4f4511890c33c2cefb5c8c.jpg, createdBy=baf03445349, createdName=花间结缡, createdTime=Wed Nov 24 13:48:45 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398195, encodeId=ded613981956e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492012, encodeId=7182149201284, content=<a href='/topic/show?id=4ff54492941' target=_blank style='color:#2F92EE;'>#妊娠高血压疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44929, encryptionId=4ff54492941, topicName=妊娠高血压疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb88907518, createdName=zhangjiqing, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016476, encodeId=7ca810164e6c9, content=俄国教育机构大天鹅梧桐树, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Sep 11 08:17:42 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016467, encodeId=8dcc101646efd, content=妊娠期各种疾病间都有关联性, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Sat Sep 11 08:04:34 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016459, encodeId=69721016459ae, content=已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Sep 11 07:41:46 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031120, encodeId=b1cf1031120f0, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052562, encodeId=a0c7105256220, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=)]
    2021-09-11 查查佳佳

    俄国教育机构大天鹅梧桐树

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1073524, encodeId=5cf210e3524ac, content=棒棒的! , beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201112/663d2bea34a2473b8f98d8cc00479b37/2ef6cb0b5b4f4511890c33c2cefb5c8c.jpg, createdBy=baf03445349, createdName=花间结缡, createdTime=Wed Nov 24 13:48:45 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398195, encodeId=ded613981956e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492012, encodeId=7182149201284, content=<a href='/topic/show?id=4ff54492941' target=_blank style='color:#2F92EE;'>#妊娠高血压疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44929, encryptionId=4ff54492941, topicName=妊娠高血压疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb88907518, createdName=zhangjiqing, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016476, encodeId=7ca810164e6c9, content=俄国教育机构大天鹅梧桐树, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Sep 11 08:17:42 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016467, encodeId=8dcc101646efd, content=妊娠期各种疾病间都有关联性, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Sat Sep 11 08:04:34 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016459, encodeId=69721016459ae, content=已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Sep 11 07:41:46 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031120, encodeId=b1cf1031120f0, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052562, encodeId=a0c7105256220, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=)]
    2021-09-11 医者仁者

    妊娠期各种疾病间都有关联性

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1073524, encodeId=5cf210e3524ac, content=棒棒的! , beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201112/663d2bea34a2473b8f98d8cc00479b37/2ef6cb0b5b4f4511890c33c2cefb5c8c.jpg, createdBy=baf03445349, createdName=花间结缡, createdTime=Wed Nov 24 13:48:45 CST 2021, time=2021-11-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1398195, encodeId=ded613981956e, content=<a href='/topic/show?id=8bee565436d' target=_blank style='color:#2F92EE;'>#损伤#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=36, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=56543, encryptionId=8bee565436d, topicName=损伤)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eoNX3lUOlDKGBUEPNwZx0nibmdcFyeibnX4WMhUSCU2REpGRWtSmnT2CCs0dA5waxvJknYDxwtYnIcQ/132, createdBy=294e2500218, createdName=ms3046638856685384, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1492012, encodeId=7182149201284, content=<a href='/topic/show?id=4ff54492941' target=_blank style='color:#2F92EE;'>#妊娠高血压疾病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44929, encryptionId=4ff54492941, topicName=妊娠高血压疾病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=6bb88907518, createdName=zhangjiqing, createdTime=Sun Sep 12 15:06:52 CST 2021, time=2021-09-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016476, encodeId=7ca810164e6c9, content=俄国教育机构大天鹅梧桐树, beContent=null, objectType=article, channel=null, level=null, likeNumber=69, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIrrxxDxnLic8t6EAs38Qfwo6H2h6JMleIgb9OSYf6LMnVDkQEqUXWoSDWboibjhOBI9SJDTXweqQIA/132, createdBy=50aa5321359, createdName=查查佳佳, createdTime=Sat Sep 11 08:17:42 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016467, encodeId=8dcc101646efd, content=妊娠期各种疾病间都有关联性, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20220519/c2ab253484ee4527a2d4e9589a4821ac/45de9bf494a54becb2ea4369c9d11e85.jpg, createdBy=7a3710, createdName=医者仁者, createdTime=Sat Sep 11 08:04:34 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1016459, encodeId=69721016459ae, content=已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f03a5433387, createdName=ms5000000518166734, createdTime=Sat Sep 11 07:41:46 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1031120, encodeId=b1cf1031120f0, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=48, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1052562, encodeId=a0c7105256220, content=妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病, beContent=null, objectType=article, channel=null, level=null, likeNumber=63, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=IVF密密, createdTime=Sat Sep 11 03:06:52 CST 2021, time=2021-09-11, status=1, ipAttribution=)]
    2021-09-11 ms5000000518166734

    已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读已读

    0

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    2021-09-11 IVF密密

    妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病

    0

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    2021-09-11 IVF密密

    妊娠高血压这一类妊娠疾病,需要加强关注,甚至包括妊娠心肌病

    0

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