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    "datePublished": "2021-09-24", 
    "datePublishedReg": "2021-09-24", 
    "description": "BackgroundHypertensive disorders of pregnancy are associated with chronic kidney disease. Early detection of renal dysfunction enables implementation of strategies to prevent progression. International guidelines recommend review at 6\u20138\u00a0weeks postpartum to identify persistent hypertension and abnormal renal function, but evidence for the efficacy of this review is limited.MethodsAll women attending a specialist fetal-maternal medicine clinic for hypertensive disorders of pregnancy (pre-eclampsia, chronic hypertension, gestational hypertension) were invited for a 6\u20138\u00a0weeks postpartum review of their blood pressure and renal function in order to establish the prevalence and independent predictors of renal dysfunction. Renal dysfunction was defined as low estimated Glomerular Filtration Rate (eGFR\u2009<\u200960\u00a0ml/min/1.73\u00a0m2) or proteinuria (24-h protein excretion\u2009>\u2009150\u00a0mg or urinary albumin-to-creatinine ratio\u2009>\u20093\u00a0mg/mmol). All women attending a specialist clinic for hypertensive disorders were invited for a 6\u20138\u00a0weeks postpartum review of their blood pressure and renal function. Demographics, pregnancy and renal outcomes were prospectively collected.ResultsBetween 2013 and 2019, 740 of 1050 (70.4%) women who had a pregnancy complicated by a hypertensive disorder attended their 6\u20138\u00a0weeks postpartum visit. Renal dysfunction was present in 32% of the total cohort and in 46% and 22% of women with and without pre-eclampsia, respectively. Multivariate logistic regression demonstrated that independent predictors were pre-eclampsia, chronic hypertension, highest measured antenatal serum creatinine, highest measured antenatal 24-h urinary protein, and blood pressure\u2009\u2265\u2009140/90\u00a0mmHg at the postnatal visit.ConclusionsRenal dysfunction was present in one in three women with hypertensive disorders of pregnancy at 6\u20138\u00a0weeks postpartum. This includes women with gestational hypertension and chronic hypertension without superimposed pre-eclampsia, and thus these women should also be offered postnatal review.Graphic abstract", 
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        "issn": [
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        "name": "Journal of Nephrology", 
        "publisher": "Springer Nature", 
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        "volumeNumber": "34"
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    "keywords": [
      "hypertensive disorders", 
      "renal dysfunction", 
      "renal function", 
      "blood pressure", 
      "chronic hypertension", 
      "independent predictors", 
      "weeks postpartum", 
      "week postpartum visit", 
      "abnormal renal function", 
      "chronic kidney disease", 
      "glomerular filtration rate", 
      "multivariate logistic regression", 
      "BackgroundHypertensive disorders", 
      "persistent hypertension", 
      "MethodsAll women", 
      "renal outcomes", 
      "gestational hypertension", 
      "postnatal review", 
      "postpartum visit", 
      "postnatal visits", 
      "serum creatinine", 
      "total cohort", 
      "kidney disease", 
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      "ResultsBetween 2013", 
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      "implementation of strategies", 
      "review", 
      "predictors", 
      "proteinuria", 
      "creatinine", 
      "mmHg", 
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      "disease", 
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      "demographics", 
      "efficacy", 
      "outcomes", 
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      "regression", 
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      "assessment", 
      "evidence", 
      "protein", 
      "rate", 
      "strategies", 
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    ], 
    "name": "Postnatal assessment for renal dysfunction in women with hypertensive disorders of pregnancy", 
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