MO220
MID TERM E GFR AND ITS IMPACT ON ADVERSE PREGNANCY OUTCOMES- IMPORTANCE OF GESTATIONAL HYPERFILTERATION

The hemodynamic adaptation plays a crucial role in maintaining gestation, the clinical significance of midterm renal hyperfiltration on pregnancy outcomes is unknown. The present study was retrospective study among all pregnant ladies whose midterm eGFR wascompared with their baseline and its change from baseline was considered as a surrogatemarker for Mid term hyperfilteration among women without underlying evidence of CKD tofurther evaluate its value as a prognostic factor of the eGFR during gestation

All pregnant females aged 18-50 years whose pre gestational baseline serum creatinine was available and had a singleton pregnancy were included in the study .The study was conducted from January 2015 till December 2018 in a tertiary care Institute in Northern India . MRH was represented by the highest eGFR, which was calculated using the Chronic Kidney Disease Epidemiology Collaboration method. An adverse pregnancy event was defined by the composition of preterm birth (gestational age <37 weeks), low birth weight (<2.5 kg), and preeclampsia.

Total of 1045 pregnancies were evaluated to study. Among them, 15 , 305, 680, and 45 mothers had midterm eGFR levels of 60–90, 90–120, 120–150, and ≥150 ml/min per 1.73 m², respectively. The adjusted odds ratio and associated 95% confidence interval (95% CI) of an adverse pregnancy outcome for eGFR levels below and above the reference level of 120–150 ml/min per 1.73 m² were 1.97 (95% CI, 1.34 to 2.89; P<0.001) for ≥150 ml/min per 1.73 m²; 1.57 (95% CI, 1.23 to 2.00; P<0.001) for 90–120 ml/min per 1.73 m²; and 4.93 (95% CI, 1.97 to 12.31; P<0.001) for 60–90 ml/min per 1.73 m². Moreover, among mothers without baseline CKD, women with adverse pregnancy outcomes had less prominent MRH than those without (P<0.001)

There was an unique relationship between the midterm eGFR and adverse pregnancy outcomes, and the optimal range of midterm eGFR levels was 120–150 ml/min per 1.73 m². In those females without evident functional renal impairment, the absence of prominent MRH could be a significant risk factor for poor pregnancy outcomes