JAMA:妊娠前后血清肌酐水平变化有规律

创作:Epi汪 审核:Epi汪 02月01日
纳入加拿大243 534名孕妇,测量妊娠不同时期血清肌酐水平(SCr);
孕前SCr的平均浓度为60μmol/L,妊娠4周后开始下降,在16-32周时达到最低(平均47μmol/L);
妊娠32周后SCr开始升高,产后几周内达到最高水平(平均64μmol/L),18周左右恢复到孕前正常水平;
妊娠期95%和50%的SCr水平间差距约15μmol/L,而产后差距约20μmol/L;
根据不同妊娠时点的95%SCr水平,高出这个界值的提示其可能发生肾功能受损,应进一步诊断和治疗。
延伸阅读

JAMA [IF:44.405]

Serum Creatinine Levels Before, During, and After Pregnancy

孕前、妊娠期及产后的女性血清肌酐水平

10.1001/jama.2018.17948

01-15, Letter

Abstract & Authors:展开

Abstract:收起
Estimating 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 creatinine clearance is impractical.2 Accordingly, physicians typically rely on SCr level.

First Authors:
Ziv Harel

Correspondence Authors:
Ziv Harel

All Authors:
Ziv Harel,Eric McArthur,Michelle Hladunewich,Jade S Dirk,Ron Wald,Amit X Garg,Joel G Ray