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Serum Creatinine Levels Before, During, and After PregnancyEstimating renal function before and during pregnancy has clinical importance: kidney dysfunction can affect maternal and perinatal health.Glomerular hyperfiltration is a typical physiological adaptation to pregnancy, reflected by a decrease in levels of serum creatinine (SCr) with advancing gestational age.Creatinine-based equations used to estimate glomerular filtration may misclassify renal function during pregnancy, 1 as they depend on a steady state of creatinine balance.Moreover, a 24-hour collection of urine to measure cre-atinine clearance is impractical. 2Accordingly, physicians typically rely on SCr level.Previous studies attempted to define a normal SCr level in pregnancy, but they had few participants and may have been confounded by sampling bias. 3,4The current study was undertaken to generate gestational age-specific estimates of renal function-before, during, and after pregnancy-among women without antecedent kidney disease.
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Ziv Harel
Eric McArthur
Michelle Hladunewich
JAMA
Western University
Sunnybrook Health Science Centre
St. Michael's Hospital
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Harel et al. (Tue,) studied this question.
www.synapsesocial.com/papers/6a017814897643a80dcae61f — DOI: https://doi.org/10.1001/jama.2018.17948