#4795 PEAK SYSTOLIC VELOCITY IN THE KIDNEY INTERLOBAR ARTERIES AS A POSSIBLE SCREENING MARKER OF CKD IN PREGNANT WOMEN

Abstract

Abstract Background and Aims Currently, pregnancy is increasingly occurring in patients with CKD including patients with chronic renal failure (CRF) - CKD grade 3-5. Physiological renal hyperperfusion and glomerular hyperfiltration in pregnant women leads to a temporary decrease in serum creatinine values even in patients with CRF. Consequently, the CKD diagnosis during pregnancy may be difficult in women without a history of kidney disease, and the degree of kidney damage may be underestimated [1]. The aim of our study was to estimate Doppler sonography of the renal arteries as a possible CKD screening method in pregnant women. Method The study included 283 pregnant women (Table 1). Doppler sonography was performed in the main renal, segmental, interlobar and interlobular arteries in left and right kidney at the first, second and third trimesters of pregnancy. Peak systolic velocity (PSV), end-diastolic velocity, pulse index, resistive index and systolic-diastolic ratio were analyzed. Results PSV in the renal arteries was significantly lower in pregnant women with CKD 3-5 compared with healthy control group since 22 weeks of pregnancy. However, PSV in the interlobar arteries had a higher diagnostic value. The values of this parameter were significantly lower in pregnant women with all stages CKD compared with healthy control group. We found cut-off points of left and right interlobar arteries PSV for the diagnosis of CKD and CRF at the first, second and third trimesters of pregnancy and cut-off points of right and left interlobar arteries PSV linear combination at the second and third trimesters (Table 2). Conclusion In pregnant women, interlobar renal arteries PSV can be used as screening marker of CKD. Additionally, it allows to identify pregnant women with advanced stages of CKD. The linear combination of right and left interlobar arteries PSV has the greatest diagnostic value.