Microbial factor in perinatal chronic kidney disease outcomes

Abstract

97 patients with chronic kidney disease (CKD) of various clinical stage and duration were supervised during pregnancy. All pregnant women with CKD are at risk of urinary tract infection detected in every third patient (in 38.2% of cases) and usually showing no clinical manifectetions. This justifies the need for microbiological testing of urine. Our study proves that any degree of bacteriuria in patients with CKD and chronic renal failure during pregnancy is significant and needs to be treated by antibiotics. Frequency of bacteriuria in our investigations was different and depended on the history of urinary tract infection (UTI) before pregnancy. Patients with secondary pielonephritis had UTI during pregnancy in 70,2% cases compared to 45% in pregnant women with chronic glomerulonephritis. Gram-negative uropatogens remain the most common flora in UTI during pregnancy with E.coli having the leadership. Development/exacerbation of UTI in pregnant CKD patients influences perinatal outcomes (premature partum and intrauterine infection) and complicates early neonatal adaptation.