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\begin{document}

\title{Changes in Serum Creatinine during and after Pregnancy in Women with or
without Chronic Kidney Disease: An Observational Study}



\author[1]{Carole Marxer}%
\author[2]{Julie Paik}%
\author[2]{Min Zhuo}%
\author[2]{Rishi Desai}%
\author[2]{Katrina Wilcox Hagberg}%
\author[2]{Susan Jick}%
\author[1]{Christoph Meier}%
\author[2]{Julia Spoendlin}%
\affil[1]{University Hospital Basel}%
\affil[2]{Affiliation not available}%


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  \date{May 29, 2024}


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\begin{abstract}
Objective To characterize pregnant women with or without pre-existing
chronic kidney disease (CKD) and to describe changes in renal filtration
during and after pregnancy. Design Descriptive study. Setting UK-based
Clinical Practice Research Datalink GOLD linked to hospital data
(2000-2019). Population Pregnancies of women with or without
pre-existing CKD, categorized by median baseline eGFR
{[}ml/min/1.73m2{]} based on serum creatinine (SCr {[}mg/dl{]})
measurements (proteinuria under-recorded). Methods Description of median
SCr levels within two-week periods during and within one year after
pregnancy. Results Of 14'401 pregnancies, 84\% had a normal baseline
eGFR[?]90. In 1'932 women (13\%) with a low-normal eGFR=75-89, SCr
patterns during and after pregnancy followed the pattern of women with
normal eGFR, although at higher starting levels (median baseline
SCr=0.92, IQR=0.88-0.96). SCr levels returned to baseline by week 3/4
postpartum. In 388 women (3\%) with a moderately low baseline
eGFR=60-74, median baseline SCr levels were 1.05 (IQR=1.01-1.10) and
patterns also followed those of women with normal eGFR. However, SCr
levels increased slower in trimester 3 and reached baseline levels at
week 9/10 postpartum. 53 women (\textless{}1\%) with a low baseline
eGFR=15-59 (median baseline SCr levels=1.43, IQR=1.26-1.72) showed renal
adaptation in trimester 1/2, but increased SCr levels of 1.71
(IQR=1.32-2.36) in trimester 3 (small sample size, 10-week periods).
Conclusion The observed prolonged hyperfiltration in women with baseline
eGFR\textless{}75 may warrant closer medical surveillance. Future
studies should evaluate individual risk factors with focus on subgroups
of women with eGFR=60-74 and eGFR\textless{}60. Funding Non. Key words
Disease progression, pregnancy, nephrology, renal filtration%
\end{abstract}%



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\textbf{Hosted file}

\verb`220519_Tables_Figures_Preg-CKD-SCr_without-NR_BJOG.docx`  available at \url{https://authorea.com/users/484263/articles/570168-changes-in-serum-creatinine-during-and-after-pregnancy-in-women-with-or-without-chronic-kidney-disease-an-observational-study}\selectlanguage{english}
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