Clinical impact of preeclampsia on pregnancy outcomes in patients with IgA nephropathy

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Clinical impact of preeclampsia on pregnancy outcomes in patients with IgA nephropathy

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Co-author 1

Miho Karube karubem@ks.kyorin-u.ac.jp kyorin University Suginami Hospital Nephrology and rheumatology Tokyo Japan *

Co-author 2

Satoshi Hayakawa ahyakawa@gmail.com kyorin University Suginami Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 3

Norihiro Nishioka norihiro-nishioka@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 4

Soko Kawashima sohko@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 5

Noriko Ikegaya nori@kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 6

Nobuhiro Ayusawa nobuhiro-ayuzawa@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 7

Takahisa Kawakami kawakat@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 8

Mitsumasa Kishimoto kishimotomi@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 9

Yoshinori Komagata komagata@ks.kyorin-u.ac.jp Kyorin University Hospital Nephrology and rheumatology Tokyo Japan -

Co-author 10

Co-author 11

Co-author 12

Co-author 13

Co-author 14

Co-author 15

Introduction

The influence of preeclampsia (PE) on maternal and renal outcomes in patients with IgA nephropathy (IgAN) remains unclear. This study aimed to evaluate the clinical characteristics and renal prognosis of IgAN patients who developed PE or superimposed preeclampsia (SPE) during pregnancy.

Methods

Among 15 women with biopsy-proven IgAN who delivered at our hospital over the past five years, 5 developed PE or SPE (IgAN group). Patients with essential hypertension or diabetes mellitus were excluded. Clinical parameters—including maternal characteristics, gestational week of PE onset, delivery week, birth weight, blood pressure, renal function (serum creatinine), proteinuria (g/gCr), and serum uric acid—were retrospectively compared with those of 20 women without preexisting kidney disease who developed PE (non-IgAN group).

Results

Maternal age was similar between groups (mean 35 years), but the primiparity rate was higher in the non-IgAN group. No significant differences were observed in blood pressure, gestational age at delivery, or birth weight. However, hypertension developed earlier in the IgAN group (22 vs. 27 weeks). Before the onset of hypertension, proteinuria and serum creatinine were significantly higher in the IgAN group. At delivery, proteinuria, serum creatinine, and uric acid increased markedly in both groups, but recovery was delayed in the IgAN group. One year postpartum, 60% of IgAN patients showed progressive renal decline.

Conclusion

In pregnancies complicated by IgA nephropathy, preeclampsia tends to occur earlier and results in prolonged proteinuria and delayed renal recovery, leading to progressive renal impairment after delivery. This work was previously presented at the Japanese Society of Nephrology and the Society for Study of the Kidney in Pregnancy, held in Japan.

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