Keywords
Type 1 Diabetes
Renal Failure
How to Cite
Copyright © | All rights reserved.
The journal holds the exclusive copyright for the publication of this article under the terms of Brazilian law 9610/98.
Partial reproduction
The use of parts of the texts, figures and questionnaire of the article is free, being mandatory the citation of the authors and journal.
Total reproduction
It is expressly prohibited and must be authorized by the journal.
Abstract
Objective: To report the case of a pregnant patient with Type 1 Diabetes who had acute chronic renal failure. Case details: Pregnant gestational age of 27 weeks and 5 days, had Type 1 Diabetes and Systemic Arterial Hypertension as comorbidities, was admitted to the emergency department due to changes in obstetric ultrasound with fetal doppler in which there was fetal growth restriction and pathological uterine and umbilical arteries and CPR, with the usual middle cerebral artery and ductus venosus. During clinical follow-up, lack of glycemic control and worsening of renal function became evident, making it necessary to initiate hemodialysis. Given the worsening of the clinical condition, it was decided to resolve the pregnancy through cesarean section, after the procedure, the patient and newborns were sent for follow-up at the intensity therapy unit servisse after hospital discharge. Final considerations: The presence of chronic renal failure during pregnancy is associated with numerous maternal and fetal complications. These complications are greater the greater the loss of kidney function. Restricted intrauterine growth is increased in pregnant women with CRF. Maintaining an adequate and favorable intrauterine environment for the development of the fetus is a challenge for teams that care for patients during the gestational period.
References
ACOG. Gestational hypertension and preeclampsia 2020. Practice Bulletin, Number 222. Obstet Gynecol. 2020; 135(6): e237-e60.
BARRETT PM, et al. Adverse pregnancy outcomes and long-term maternal kidney disease: a systematic review and meta-analysis. JAMA Netw Open, 2020; (2): e1920964.
BURGNER A e HLADUNEWICH MA. Women’s reproductive health for the nephrologist. Am J Kidney Dis. 2019; 74(5): 675-81.
CABIDDU G, et al. A best practice position statement on pregnancy in chronic kidney disease: the Italian Study Group on Kidney and Pregnancy. J Nephrol., 2016; 29(3): 277-303.
FACCA TA, et al. Pré-eclâmpsia (indicador de doença renal crônica): da gênese aos riscos futuros. Braz J Nephrol., 2012; 34(1): 87–93.
AMARAL LA, et al. Pathophysiology and current clinical management of preeclampsia. Curr Hypertens Rep., 2017; 19(8): 61.
FISCHER MJ. Chronic kidney disease and pregnancy: maternal and fetal outcomes. Adv Chronic Kidney Dis., 2007; 14(2): 132-45.
GOLBERT A e CAMPOS MAA. Diabetes melito tipo 1 e gestação. Arq Bras Endocrinol Metab., 2008; 52(2): 307–14.
GOUVEIA IF, et al. Desfechos maternos e fetais da gravidez na doença renal crônica: desafios diagnósticos, vigilância e tratamento em todo o espectro da doença renal. Braz. J. Nephrol. (J. Bras. Nefrol.), 2021; 43(1): 88-102.
JUNIOR JER. Atualização em diálise: Tratamento dialítico de mulheres grávidas. J Bras Nefrol., 2001; 23(1): 49-54.
RIBEIRO CI e SILVA N. Gravidez e diálise. Braz. J. Nephrol. (J. Bras. Nefrol., 2020; 42(3): 349-356.
SALGADO PPC, et al. Fisiopatologia da nefropatia diabética. Brazilian Journal of Health Review, 2022; 5(1) 3615-3637.
TREVISAN G. Gestação em pacientes com Insuficiência Renal Crônica. Dissertação (Mestrado em Nefrologia). Universidade Federal do Rio Grande do Sul, 2023; 67p.
ZUGAIB M. Zugaib obstetrícia. Barueri, SP: Manole., 2020; 1406p.
VAN BALEN VAL, et al. Maternal kidney function during pregnancy: a systematic review and meta-analysis. Ultrasound Obstet Gynecol., 2019; 54(3): 297-307.