Understanding the link between kidney health and pregnancy outcomes

了解肾脏健康与妊娠结局之间的联系

• 批准号: MR/Y011139/1
• 负责人: Kate Birnie
• 金额: $ 146.27万
• 依托单位: University of Bristol
• 依托单位国家: 英国
• 项目类别: Fellowship
• 财政年份: 2024
• 资助国家: 英国
• 起止时间: 2024 至 无数据
• 项目状态: 未结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FY011139%2F1
• 关键词: Understanding; link; between; kidney; health

Reproductive health is important to a woman's overall health and well-being and is increasingly recognised as a sex specific marker for diseases in later life. Women who experience complications of pregnancy, such as pre-eclampsia, are more likely to have heart disease in later life for example. However, there are gaps in our knowledge about whether women who experience complications of pregnancy are more likely to experience reduced kidney function and kidney disease in later life. I will use information from several studies, including large datasets of routinely collected clinical data and smaller studies with detailed measurements, to examine if women who experience different complications in pregnancy are at greater risk of reduced kidney function and kidney disease in later life. Understanding the relationship between women's reproductive health and later disease is important as it may identify the need for increased monitoring of kidney function after pregnancy, crucially as some of the causes of kidney disease are preventable. Women at high risk can then be offered advice or treatment that will lower that risk.There are also gaps in knowledge about whether women who have reduced kidney function prior to pregnancy are at greater risk of developing pregnancy complications. Here, I will measure kidney function prior to pregnancy, in early pregnancy, and throughout pregnancy, to examine if women with reduced kidney function are at greater risk of pregnancy complications such as pre-eclampsia and diabetes in pregnancy. This is important as women are increasingly having children at older ages, and it is vital that we understand what affects women's chances of having a healthy pregnancy. Finally, if kidney function needs to be tested in pregnancy, a substance in the blood called creatinine is measured. However, there is no clear guidance on acceptable levels in pregnancy. I will use multiple studies to address this knowledge gap and with the aim of establishing the normal/acceptable range. I will also examine an alternative measures of kidney function, cystatin C. Unlike creatinine, cystatin C is produced from all cells in the body, rather than just muscles, and so isn't affected by things like muscle mass. The work will provide insights into how women should be managed if changes in creatinine are observed during pregnancy.

生殖健康对于女性的整体健康和福祉非常重要，并且越来越多地被认为是晚年疾病的性别特异性标志。例如，经历妊娠并发症（例如先兆子痫）的女性在以后的生活中更有可能患心脏病。然而，对于经历妊娠并发症的女性是否更有可能在以后的生活中出现肾功能下降和肾脏疾病，我们的知识还存在空白。我将使用多项研究的信息，包括常规收集的临床数据的大型数据集和详细测量的小型研究，来检查在怀孕期间经历不同并发症的女性是否在以后的生活中面临更大的肾功能下降和肾脏疾病的风险。了解女性生殖健康与后期疾病之间的关系很重要，因为它可能会确定怀孕后加强肾功能监测的必要性，最重要的是，因为肾脏疾病的一些原因是可以预防的。然后，可以为高危女性提供降低风险的建议或治疗。对于怀孕前肾功能下降的女性是否更有可能出现妊娠并发症的风险，目前还存在认识上的空白。在这里，我会在孕前、孕早期和整个孕期对肾功能进行测量，以检查肾功能下降的女性是否在孕期发生先兆子痫、糖尿病等妊娠并发症的风险更大。这一点很重要，因为女性越来越多地在高龄生孩子，而且我们了解影响女性健康怀孕机会的因素也至关重要。最后，如果怀孕期间需要检查肾功能，则需要测量血液中一种称为肌酐的物质。然而，对于怀孕期间可接受的水平没有明确的指导。我将利用多项研究来解决这一知识差距，并旨在建立正常/可接受的范围。我还将检查肾功能的替代指标胱抑素 C。与肌酐不同，胱抑素 C 是由体内所有细胞产生的，而不仅仅是肌肉，因此不受肌肉质量等因素的影响。这项工作将为女性在怀孕期间观察到肌酐变化时应如何管理提供见解。