Most Read Articles
Roshini Claire Anthony, 5 days ago

A genotype-guided approach to warfarin dosing may result in fewer dose adjustments in Asian patients, according to a study from Singapore.

10 Aug 2018

Fungal microbiome, also called the mycobiome, appears to be highly variable in patients with well-characterized fungal diseases, a recent study has shown. Moreover, severe asthmatics have the highest fungal loads, along with those receiving steroid and antifungal therapy.

Tristan Manalac, 6 days ago
The risk of complicated appendicitis is lower in children with IgE-mediated allergy, according to a recent study.
21 Jul 2018
Although many patients with atopic dermatitis (AD) use antihistamines, no high-level evidence exists to prove that nonsedating antihistamines reduce itch in patients with AD or provide benefit in controlling AD symptoms, except perhaps sleep and AD comorbidities such as allergic rhinitis, according to a study.

Clinically recovered AKI linked to elevated pre-eclampsia risk

08 Aug 2018

Women with a history of acute kidney injury (AKI) before pregnancy, despite apparent full recovery, are at greater risk of pregnancy complications such as pre-eclampsia, a study has found. This risk is modified by severity of the AKI episode.

Researchers examined the medical records of 14,486 women with singleton deliveries, among whom 246 had an episode of clinically recovered AKI (r-AKI) before conception. Women with r-AKI and controls had similar age (mean, 31 years) and body mass index (mean, 26.7 kg/m2) at first prenatal visit, although the former were more likely to have pre-existing diabetes mellitus (9 percent vs 5 percent; p=0.006).

In terms of pregnancy outcomes, the r-AKI had a higher rate of pre-eclampsia compared with non-r-AKI controls (22 percent vs 9 percent; p<0.001). Furthermore, infants of women in the r-AKI group were born earlier (gestational age, 38.2 vs 39.0 weeks; p<0.001) and were more likely to be small for gestational age (9 percent vs 5 percent; p=0.002).

The risk of pre-eclampsia increased with increasing severity of r-AKI. Specifically, the risk of the pregnancy complication was about threefold high in women who had had stage 2 AKI (adjusted odds ratio [OR], 3.5; 95 percent CI, 2.1–5.7) and about sixfold greater in those who had had stage 3 AKI (adjusted OR, 6.5; 3.5–12.0). This risk increase was not observed for stage 1 AKI (adjusted OR, 1.7; 0.9–3.2).

The present data indicate that reversible AKI is not harmless, researchers said. This has important implications for pregnancy counselling, underscoring the importance of active evaluation for episodes of AKI, as well as of AKI prevention, especially in young women.

Researchers postulated that women with clinically recovered AKI, especially those with severe AKI, have residual subclinical kidney disease and lower nephron mass prior to conceiving. Low nephron number and surrogates for low renal mass have been associated with adverse long-term health consequences, including hypertension and CKD, as well as gestational hypertension and pre-eclampsia. [J Am Soc Nephrol 2010;21:898-910; Am J Kidney Dis 2017;70:506-511]

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS JPOG - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Roshini Claire Anthony, 5 days ago

A genotype-guided approach to warfarin dosing may result in fewer dose adjustments in Asian patients, according to a study from Singapore.

10 Aug 2018

Fungal microbiome, also called the mycobiome, appears to be highly variable in patients with well-characterized fungal diseases, a recent study has shown. Moreover, severe asthmatics have the highest fungal loads, along with those receiving steroid and antifungal therapy.

Tristan Manalac, 6 days ago
The risk of complicated appendicitis is lower in children with IgE-mediated allergy, according to a recent study.
21 Jul 2018
Although many patients with atopic dermatitis (AD) use antihistamines, no high-level evidence exists to prove that nonsedating antihistamines reduce itch in patients with AD or provide benefit in controlling AD symptoms, except perhaps sleep and AD comorbidities such as allergic rhinitis, according to a study.