Evidence map›Paper›PMID 32092759›Full record

ArticleNephron2020

Pregnancy in Advanced Kidney Disease: Clinical Practice Considerations on a Challenging Combination.

Rozemarijn Snoek, Rieke van der Graaf, Jildau R Meinderts, Franka van Reekum, Kitty W M Bloemenkamp, Nine V A M Knoers, Albertien M van Eerde, A Titia Lely

Abstract read
In one paragraph

Article in Nephron, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Guideline
  2. Pooled it
  3. Review
  4. Article
  5. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Rozemarijn SnoekDepartment of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Rieke van der GraafDepartment of Medical Humanities, Julius Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Jildau R MeindertsDepartment of Nephrology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Franka van ReekumDepartment of Nephrology, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Kitty W M BloemenkampDepartment of Obstetrics, Birth Centre Wilhelmina Children's Hospital, University Medical Center Utrecht, Division Women and Baby, Utrecht University, Utrecht, The Netherlands.
Nine V A M KnoersDepartment of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Albertien M van EerdeDepartment of Genetics, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
A Titia LelyDepartment of Obstetrics, Birth Centre Wilhelmina Children's Hospital, University Medical Center Utrecht, Division Women and Baby, Utrecht University, Utrecht, The Netherlands, a.t.lely@umcutrecht.nl.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThanks to the advances in care, pregnancy is now attainable for the majority of young female CKD patients, although it is still a high-risk endeavor. Clinical decision-making in these cases is impacted by a myriad of factors, making (pre)pregnancy counseling a complex process. The complexities, further impacted by limited data and unknown risks regarding outcome, can cause discussions when deciding on the best care for a specific patient.

objectivesIn this article, we provide an overview of the considerations and dilemmas we encounter in preconception counseling and offer our perspective on how to deal with them in daily clinical practice.

methodsThe main topics we discuss in our counseling are (1) the high risk of pregnancy complications, (2) the risk of permanent CKD deterioration due to pregnancy and subsequent decreased life expectancy, (3) appropriate changes in renal medication, and (4) assisted reproduction, genetic testing, and prenatal or preimplantation genetic diagnostics. RESULTS AND

conclusionsIn our clinic, we openly address moral dilemmas arising in clinical practice in pregnancy and CKD, both within the physician team and with the patient. We do this by ensuring an interpretive physician-patient interaction and shared decision-making, deliberating in a multidisciplinary setting and, if needed, with input from an expert committee.

Indexed as

CounselingFemaleGenetic TestingHumansKidneyLife ExpectancyPregnancyPregnancy ComplicationsPrenatal DiagnosisRenal Insufficiency, ChronicReproductive Techniques, AssistedChronic kidney diseaseGenetic kidney diseasePregnancyPreimplantation genetic diagnostics

Identifiers

PMID32092759
PMCPMC7212694

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.