PROTEINURIA - A RISK FACTOR FOR PREGNANCY-RELATED RENAL-FUNCTION DECLINE IN PRIMARY GLOMERULAR-DISEASE

Pregnancy may be followed by a postpartum acceleration of renal functi on loss in patients with renal disease. We retrospectively analyzed th e effects of pregnancy on progressive renal function decline, and the risk factors for an acceleration, in a group of 19 renal disease patie nts with 30 pregnancies and a group of 31 patients who did not become pregnant after onset of glomerular disease. The rate of renal function loss was calculated for each patient by linear regression on reciproc al serum creatinine values over 11 years' follow-up. Multiple regressi on analysis showed that both pregnancy (P = 0.03) and initial proteinu ria (P = 0.005) were independently related with the rate of renal func tion loss. Such a relation could not be observed with histologic diagn osis, and initial age, renal function, blood pressure, and serum album in, Further analysis showed that 10 of 30 pregnancies are followed by a predefined acceleration of renal function loss. These pregnancies we re preceded and complicated by a higher proteinuria (4.1 v 1.7 g/d, P < 0.005; and 3.6 v 2.1 g/d, P < 0.05, respectively) compared with the other 20 pregnancies that are not followed by such an acceleration. In conclusion, patients with primary glomerular disease complicated by s ubstantial proteinuria are at risk for acceleration of renal function decline after pregnancy. (C) 1995 by the National Kidney Foundation, I nc.