Comparison of pregnancy outcomes in Dutch kidney recipients with and without calcineurin inhibitor exposure: a retrospective study
Summary Within pregnancies occurring between 1986 and 2017 in Dutch kidney transplant recipients (KTR), we retrospectively compared short‐term maternal and foetal outcomes between patients on calcineurin inhibitor (CNI) based (CNI+) and CNI‐free immunosuppression (CNI−). We identified 129 CNI+ and 1...
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| Veröffentlicht in: | Transplant international 2021-12, Vol.34 (12), p.2669-2679 |
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| creator | Koenjer, Lisanne M. Meinderts, Jildau R. Heijden, Olivier W. H. Lely, Titia Jong, Margriet F. C. Molen, Renate G. Hamersvelt, Henk W. Bemelman, FJ de Boer, M Christiaans, MHL Groenewout, M Ganzevoort, W Nurmohammed, SA van Reekum, FE Rischen‐Vos, J Spaanderman, MEA Sueters, M Visser, W de Vries, APJ |
| description | Summary
Within pregnancies occurring between 1986 and 2017 in Dutch kidney transplant recipients (KTR), we retrospectively compared short‐term maternal and foetal outcomes between patients on calcineurin inhibitor (CNI) based (CNI+) and CNI‐free immunosuppression (CNI−). We identified 129 CNI+ and 125 CNI− pregnancies in 177 KTR. Demographics differed with CNI+ having higher body mass index (P = 0.045), shorter transplant‐pregnancy interval (P |
| doi_str_mv | 10.1111/tri.14156 |
| format | Article |
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Within pregnancies occurring between 1986 and 2017 in Dutch kidney transplant recipients (KTR), we retrospectively compared short‐term maternal and foetal outcomes between patients on calcineurin inhibitor (CNI) based (CNI+) and CNI‐free immunosuppression (CNI−). We identified 129 CNI+ and 125 CNI− pregnancies in 177 KTR. Demographics differed with CNI+ having higher body mass index (P = 0.045), shorter transplant‐pregnancy interval (P < 0.01), later year of transplantation and ‐pregnancy (P < 0.01). Serum creatinine levels were numerically higher in CNI+ in all study phases, but only reached statistical significance in third trimester (127 vs. 105 µm; P < 0.01), where the percentual changes from preconceptional level also differed (+3.1% vs. −2.2% in CNI−; P = 0.05). Postpartum both groups showed 11–12% serum creatinine rise from preconceptional level. Incidence of low birth weight (LBW) tended to be higher in CNI+ (52% vs. 46%; P = 0.07). Both groups showed equal high rates of preterm delivery. Using CNIs during pregnancy lead to a rise in creatinine in the third trimester but does not negatively influence the course of graft function in the first year postpartum or direct foetal outcomes. High rates of preterm delivery and LBW in KTR, irrespective of CNI use, classify all pregnancies as high risk.
A retrospective study with all Dutch pregnant kidney transplant recipients in 1986–2017, where maternal and foetal pregnancy outcomes were compared between patients using a CNI immunosuppressive regimen and patients, not using CNIs.</description><identifier>ISSN: 0934-0874</identifier><identifier>EISSN: 1432-2277</identifier><identifier>DOI: 10.1111/tri.14156</identifier><identifier>PMID: 34797607</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>azathioprine ; Birth weight ; Body mass ; Body mass index ; Body size ; Calcineurin ; Calcineurin inhibitors ; Calcineurin Inhibitors - adverse effects ; Creatinine ; Demography ; Female ; Graft Rejection ; Humans ; Immunosuppression ; Immunosuppressive Agents - adverse effects ; Infant, Newborn ; Inhibitors ; Kidney ; Kidney transplantation ; Kidney Transplantation - adverse effects ; Kidney transplants ; Kidneys ; Low birth weight ; Netherlands ; Original ; Original : Clinical Research ; Postpartum ; Pregnancy ; Pregnancy Outcome ; Retrospective Studies ; Transplantation ; Transplants & implants</subject><ispartof>Transplant international, 2021-12, Vol.34 (12), p.2669-2679</ispartof><rights>2021 The Authors. published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT</rights><rights>2021 The Authors. Transplant International published by John Wiley & Sons Ltd on behalf of Steunstichting ESOT.</rights><rights>2021. This article is published under http://creativecommons.org/licenses/by-nc-nd/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4436-708d81c172b283a31f5cf729f6a0d7b49ce46e9995b73501b0d158a4fda25b723</citedby><cites>FETCH-LOGICAL-c4436-708d81c172b283a31f5cf729f6a0d7b49ce46e9995b73501b0d158a4fda25b723</cites><orcidid>0000-0003-3798-6443 ; 0000-0001-8714-4338 ; 0000-0001-7347-4344 ; 0000-0003-4676-472X ; 0000-0003-3113-6587 ; 0000-0001-6356-7707 ; 0000-0001-8037-0615</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Ftri.14156$$EPDF$$P50$$Gwiley$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Ftri.14156$$EHTML$$P50$$Gwiley$$Hfree_for_read</linktohtml><link.rule.ids>230,314,776,780,881,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/34797607$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Koenjer, Lisanne M.</creatorcontrib><creatorcontrib>Meinderts, Jildau R.</creatorcontrib><creatorcontrib>Heijden, Olivier W. H.</creatorcontrib><creatorcontrib>Lely, Titia</creatorcontrib><creatorcontrib>Jong, Margriet F. C.</creatorcontrib><creatorcontrib>Molen, Renate G.</creatorcontrib><creatorcontrib>Hamersvelt, Henk W.</creatorcontrib><creatorcontrib>Bemelman, FJ</creatorcontrib><creatorcontrib>de Boer, M</creatorcontrib><creatorcontrib>Christiaans, MHL</creatorcontrib><creatorcontrib>Groenewout, M</creatorcontrib><creatorcontrib>Ganzevoort, W</creatorcontrib><creatorcontrib>Nurmohammed, SA</creatorcontrib><creatorcontrib>van Reekum, FE</creatorcontrib><creatorcontrib>Rischen‐Vos, J</creatorcontrib><creatorcontrib>Spaanderman, MEA</creatorcontrib><creatorcontrib>Sueters, M</creatorcontrib><creatorcontrib>Visser, W</creatorcontrib><creatorcontrib>de Vries, APJ</creatorcontrib><creatorcontrib>Members of the PARTOUT network</creatorcontrib><title>Comparison of pregnancy outcomes in Dutch kidney recipients with and without calcineurin inhibitor exposure: a retrospective study</title><title>Transplant international</title><addtitle>Transpl Int</addtitle><description>Summary
Within pregnancies occurring between 1986 and 2017 in Dutch kidney transplant recipients (KTR), we retrospectively compared short‐term maternal and foetal outcomes between patients on calcineurin inhibitor (CNI) based (CNI+) and CNI‐free immunosuppression (CNI−). We identified 129 CNI+ and 125 CNI− pregnancies in 177 KTR. Demographics differed with CNI+ having higher body mass index (P = 0.045), shorter transplant‐pregnancy interval (P < 0.01), later year of transplantation and ‐pregnancy (P < 0.01). Serum creatinine levels were numerically higher in CNI+ in all study phases, but only reached statistical significance in third trimester (127 vs. 105 µm; P < 0.01), where the percentual changes from preconceptional level also differed (+3.1% vs. −2.2% in CNI−; P = 0.05). Postpartum both groups showed 11–12% serum creatinine rise from preconceptional level. Incidence of low birth weight (LBW) tended to be higher in CNI+ (52% vs. 46%; P = 0.07). Both groups showed equal high rates of preterm delivery. Using CNIs during pregnancy lead to a rise in creatinine in the third trimester but does not negatively influence the course of graft function in the first year postpartum or direct foetal outcomes. High rates of preterm delivery and LBW in KTR, irrespective of CNI use, classify all pregnancies as high risk.
A retrospective study with all Dutch pregnant kidney transplant recipients in 1986–2017, where maternal and foetal pregnancy outcomes were compared between patients using a CNI immunosuppressive regimen and patients, not using CNIs.</description><subject>azathioprine</subject><subject>Birth weight</subject><subject>Body mass</subject><subject>Body mass index</subject><subject>Body size</subject><subject>Calcineurin</subject><subject>Calcineurin inhibitors</subject><subject>Calcineurin Inhibitors - adverse effects</subject><subject>Creatinine</subject><subject>Demography</subject><subject>Female</subject><subject>Graft Rejection</subject><subject>Humans</subject><subject>Immunosuppression</subject><subject>Immunosuppressive Agents - adverse effects</subject><subject>Infant, Newborn</subject><subject>Inhibitors</subject><subject>Kidney</subject><subject>Kidney transplantation</subject><subject>Kidney Transplantation - adverse effects</subject><subject>Kidney transplants</subject><subject>Kidneys</subject><subject>Low birth weight</subject><subject>Netherlands</subject><subject>Original</subject><subject>Original : Clinical Research</subject><subject>Postpartum</subject><subject>Pregnancy</subject><subject>Pregnancy Outcome</subject><subject>Retrospective Studies</subject><subject>Transplantation</subject><subject>Transplants & implants</subject><issn>0934-0874</issn><issn>1432-2277</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>24P</sourceid><sourceid>EIF</sourceid><recordid>eNp1kdFr1TAUxoMo7u7qg_-ABHzRh25JmjSND4JcnQ4GgsznkKanu5ltUpN2s6_7y83unWMTDIEcku_7cU4-hF5RckTzOp6iO6KciuoJWlFesoIxKZ-iFVElL0gt-QE6TOmSEMJqQZ6jg5JLJSsiV-hmE4bRRJeCx6HDY4QLb7xdcJgnGwZI2Hn8Kddb_NO1HhYcwbrRgZ8SvnbTFhvf7opswNb01nmYYzY5v3WNm0LE8HsMaY7wHpvsnmJII9jJXQFO09wuL9CzzvQJXt6da_Tj5PP55mtx9u3L6ebjWWE5L6tCkrqtqaWSNawuTUk7YTvJVFcZ0sqGKwu8AqWUaGQpCG1IS0VteNcalq9YuUYf9txxbgZobR4hml6P0Q0mLjoYpx-_eLfVF-FKK5apUmTA2ztADL9mSJMeXLLQ98ZDmJNmQila0zLvNXrzj_QyzNHn8TSrqGCKyl1H7_Yqm_8kRejum6FE3yarc7J6l2zWvn7Y_b3yb5RZcLwXXLselv-T9Pn30z3yDxqesP8</recordid><startdate>202112</startdate><enddate>202112</enddate><creator>Koenjer, Lisanne M.</creator><creator>Meinderts, Jildau R.</creator><creator>Heijden, Olivier W. H.</creator><creator>Lely, Titia</creator><creator>Jong, Margriet F. C.</creator><creator>Molen, Renate G.</creator><creator>Hamersvelt, Henk W.</creator><creator>Bemelman, FJ</creator><creator>de Boer, M</creator><creator>Christiaans, MHL</creator><creator>Groenewout, M</creator><creator>Ganzevoort, W</creator><creator>Nurmohammed, SA</creator><creator>van Reekum, FE</creator><creator>Rischen‐Vos, J</creator><creator>Spaanderman, MEA</creator><creator>Sueters, M</creator><creator>Visser, W</creator><creator>de Vries, APJ</creator><general>Blackwell Publishing Ltd</general><general>John Wiley and Sons Inc</general><scope>24P</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>K9.</scope><scope>P64</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0003-3798-6443</orcidid><orcidid>https://orcid.org/0000-0001-8714-4338</orcidid><orcidid>https://orcid.org/0000-0001-7347-4344</orcidid><orcidid>https://orcid.org/0000-0003-4676-472X</orcidid><orcidid>https://orcid.org/0000-0003-3113-6587</orcidid><orcidid>https://orcid.org/0000-0001-6356-7707</orcidid><orcidid>https://orcid.org/0000-0001-8037-0615</orcidid></search><sort><creationdate>202112</creationdate><title>Comparison of pregnancy outcomes in Dutch kidney recipients with and without calcineurin inhibitor exposure: a retrospective study</title><author>Koenjer, Lisanne M. ; Meinderts, Jildau R. ; Heijden, Olivier W. H. ; Lely, Titia ; Jong, Margriet F. C. ; Molen, Renate G. ; Hamersvelt, Henk W. ; Bemelman, FJ ; de Boer, M ; Christiaans, MHL ; Groenewout, M ; Ganzevoort, W ; Nurmohammed, SA ; van Reekum, FE ; Rischen‐Vos, J ; Spaanderman, MEA ; Sueters, M ; Visser, W ; de Vries, APJ</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4436-708d81c172b283a31f5cf729f6a0d7b49ce46e9995b73501b0d158a4fda25b723</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>azathioprine</topic><topic>Birth weight</topic><topic>Body mass</topic><topic>Body mass index</topic><topic>Body size</topic><topic>Calcineurin</topic><topic>Calcineurin inhibitors</topic><topic>Calcineurin Inhibitors - adverse effects</topic><topic>Creatinine</topic><topic>Demography</topic><topic>Female</topic><topic>Graft Rejection</topic><topic>Humans</topic><topic>Immunosuppression</topic><topic>Immunosuppressive Agents - adverse effects</topic><topic>Infant, Newborn</topic><topic>Inhibitors</topic><topic>Kidney</topic><topic>Kidney transplantation</topic><topic>Kidney Transplantation - adverse effects</topic><topic>Kidney transplants</topic><topic>Kidneys</topic><topic>Low birth weight</topic><topic>Netherlands</topic><topic>Original</topic><topic>Original : Clinical Research</topic><topic>Postpartum</topic><topic>Pregnancy</topic><topic>Pregnancy Outcome</topic><topic>Retrospective Studies</topic><topic>Transplantation</topic><topic>Transplants & implants</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koenjer, Lisanne M.</creatorcontrib><creatorcontrib>Meinderts, Jildau R.</creatorcontrib><creatorcontrib>Heijden, Olivier W. 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H.</au><au>Lely, Titia</au><au>Jong, Margriet F. C.</au><au>Molen, Renate G.</au><au>Hamersvelt, Henk W.</au><au>Bemelman, FJ</au><au>de Boer, M</au><au>Christiaans, MHL</au><au>Groenewout, M</au><au>Ganzevoort, W</au><au>Nurmohammed, SA</au><au>van Reekum, FE</au><au>Rischen‐Vos, J</au><au>Spaanderman, MEA</au><au>Sueters, M</au><au>Visser, W</au><au>de Vries, APJ</au><aucorp>Members of the PARTOUT network</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Comparison of pregnancy outcomes in Dutch kidney recipients with and without calcineurin inhibitor exposure: a retrospective study</atitle><jtitle>Transplant international</jtitle><addtitle>Transpl Int</addtitle><date>2021-12</date><risdate>2021</risdate><volume>34</volume><issue>12</issue><spage>2669</spage><epage>2679</epage><pages>2669-2679</pages><issn>0934-0874</issn><eissn>1432-2277</eissn><abstract>Summary
Within pregnancies occurring between 1986 and 2017 in Dutch kidney transplant recipients (KTR), we retrospectively compared short‐term maternal and foetal outcomes between patients on calcineurin inhibitor (CNI) based (CNI+) and CNI‐free immunosuppression (CNI−). We identified 129 CNI+ and 125 CNI− pregnancies in 177 KTR. Demographics differed with CNI+ having higher body mass index (P = 0.045), shorter transplant‐pregnancy interval (P < 0.01), later year of transplantation and ‐pregnancy (P < 0.01). Serum creatinine levels were numerically higher in CNI+ in all study phases, but only reached statistical significance in third trimester (127 vs. 105 µm; P < 0.01), where the percentual changes from preconceptional level also differed (+3.1% vs. −2.2% in CNI−; P = 0.05). Postpartum both groups showed 11–12% serum creatinine rise from preconceptional level. Incidence of low birth weight (LBW) tended to be higher in CNI+ (52% vs. 46%; P = 0.07). Both groups showed equal high rates of preterm delivery. Using CNIs during pregnancy lead to a rise in creatinine in the third trimester but does not negatively influence the course of graft function in the first year postpartum or direct foetal outcomes. High rates of preterm delivery and LBW in KTR, irrespective of CNI use, classify all pregnancies as high risk.
A retrospective study with all Dutch pregnant kidney transplant recipients in 1986–2017, where maternal and foetal pregnancy outcomes were compared between patients using a CNI immunosuppressive regimen and patients, not using CNIs.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>34797607</pmid><doi>10.1111/tri.14156</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0003-3798-6443</orcidid><orcidid>https://orcid.org/0000-0001-8714-4338</orcidid><orcidid>https://orcid.org/0000-0001-7347-4344</orcidid><orcidid>https://orcid.org/0000-0003-4676-472X</orcidid><orcidid>https://orcid.org/0000-0003-3113-6587</orcidid><orcidid>https://orcid.org/0000-0001-6356-7707</orcidid><orcidid>https://orcid.org/0000-0001-8037-0615</orcidid><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | azathioprine Birth weight Body mass Body mass index Body size Calcineurin Calcineurin inhibitors Calcineurin Inhibitors - adverse effects Creatinine Demography Female Graft Rejection Humans Immunosuppression Immunosuppressive Agents - adverse effects Infant, Newborn Inhibitors Kidney Kidney transplantation Kidney Transplantation - adverse effects Kidney transplants Kidneys Low birth weight Netherlands Original Original : Clinical Research Postpartum Pregnancy Pregnancy Outcome Retrospective Studies Transplantation Transplants & implants |
| title | Comparison of pregnancy outcomes in Dutch kidney recipients with and without calcineurin inhibitor exposure: a retrospective study |
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