ArticleNephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association2023
Adding creatinine to routine pregnancy tests: a decision tree for calculating the cost of identifying patients with CKD in pregnancy.
Article in Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- Chronic kidney disease, female infertility, and medically assisted reproduction: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology.Journal of nephrology · 2023Guideline
- Significant kidney disease in pregnancy: Feasibility and outcomes of a national population-based study using the Australasian Maternity Outcomes Surveillance System.The Australian & New Zealand journal of obstetrics & gynaecology · 2025Article
- Severe kidney dysfunction after assisted reproductive technology: a case series suggesting the need for higher awareness of risks.Journal of nephrology · 2025Article
- Incidence and clinical outcomes of pregnancy-related acute kidney injury (PrAKI) in preeclampsia-complicated pregnancies in Saudi Arabia: a single-center experience.Journal of nephrology · 2025Article
- Pregnancy as a Window to Current and Future Kidney Health-An Opportunity.Kidney international reports · 2025Article
- Second Trimester Kidney Function and Adverse Pregnancy Outcomes among Patients with Lupus.Kidney360 · 2025Article
- Defining normal serum creatinine in pregnancy-results from the AKID UK prospective cohort study.Clinical kidney journal · 2025Article
- Pre-gestational counselling for women living with CKD: starting from the bright side.Clinical kidney journal · 2024Review
- Women should not die of pregnancy-related acute kidney injury (PRAKI): revealing the underwater iceberg of maternal health.Journal of nephrology · 2024Article
- Access to Nephrology Care for Pregnancy-Related Acute Kidney Injury in Low- and Lower-Middle-Income Countries: A Perspective.Kidney medicine · 2023Article
- Kidney diseases in women: difference in risks and opportunities.Revista da Associacao Medica Brasileira (1992) · 2023Article
- The Hypertensive Disorders of Pregnancy: A Focus on Definitions for Clinical Nephrologists.Journal of clinical medicine · 2022Review
- Pregnancy and Kidney Diseases: Multidisciplinary Follow-Up and the Vicious Circles Involving Pregnancy and CKD, Preeclampsia, Preterm Delivery and the Kidneys.Journal of clinical medicine · 2022Article
- The effects of pregnancy on the progression of maternal glomerular disease.Jornal brasileiro de nefrologiaArticle
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Authors and funding
9 authors at 6 institutions in 2 countries.
Funding
Abstract
backgroundEven in its early stages, chronic kidney disease (CKD) is associated with adverse pregnancy outcomes. The current guidelines for pregnancy management suggest identifying risk factors for adverse outcomes but do not mention kidney diseases. Since CKD is often asymptomatic, pregnancy offers a valuable opportunity for diagnosis. The present analysis attempts to quantify the cost of adding serum creatinine to prenatal screening and monitoring tests.
methodsThe decision tree we built takes several screening scenarios (before, during and after pregnancy) into consideration, following the hypothesis that while 1:750 pregnant women are affected by stage 4-5 CKD and 1:375 by stage 3B, only 50% of CKD cases are known. Prevalence of abortions/miscarriages was calculated at 30%; compliance with tests was hypothesized at 50% pre- and post-pregnancy and 90% during pregnancy (30% for miscarriages); the cost of serum creatinine (production cost) was set at 0.20 euros. A downloadable calculator, which makes it possible to adapt these figures to other settings, is available.
resultsThe cost per detected CKD case ranged from 111 euros (one test during pregnancy, diagnostic yield 64.8%) to 281.90 euros (one test per trimester, plus one post-pregnancy or miscarriage, diagnostic yield 87.7%). The best policy is identified as one test pre-, one during and one post-pregnancy (191.80 euros, diagnostic yield 89.4%).
conclusionsThis study suggests the feasibility of early CKD diagnosis in pregnancy by adding serum creatinine to routinely performed prenatal tests and offers cost estimates for further discussion.
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