Introduction:
Midterm renal hyperfiltration (MRH) is a unique physiological phenomenon of hemodynamic adaptation that develops early in gestation and persists until parturition. An increase of 30%–50% in the estimated glomerular filtration rate (eGFR) or an absolute eGFR value >120 ml/min per 1.73m2 at 20 weeks of gestation is considered normal MRH. This prospective study, studied the relationship between midterm eGFR, its change from baseline and adverse pregnancy outcomes.
Methods:
In this prospective study, 210 pregnant women without any prior underlying renal dysfunction and chronic diseases affecting gestation were included. Serum creatinine and eGFR (CKD-EPI equation) were recorded at baseline, 20 weeks and patients were closely monitored till delivery.
Results:
The mean age was 26.55±0.297 years with a baseline creatinine and eGFR of 0.813±0.07 and 100.56±0.693 respectively. Mean midterm eGFR was 131.06±0.637 with a MRH incidence of 64%. Patients without MRH were found to have significantly higher age and parity. The incidence of adverse pregnancy outcomes (preeclampsia, preterm, and low birth weight) was significantly higher in patients without MRH. The relative risk for developing complications at delivery in the non MRH group compared to MRH group was 4.937(p=0.0001). Patients with midterm eGFR <120 were found to have higher risk of complications compared to GFR >120.
Conclusions:
The increase in age and multiparity were the risk factors for lower MRH which in turn is associated wit h individual and composite adverse gestational outcomes. Comparing the midterm eGFR categories, higher categories experienced lesser pregnancy complications.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.