Prevalence of Infertility and Pregnancy Loss Among Individuals with Kidney Disease in the Hispanic Community Health Study/Study of Latinos

Overview

Journal Womens Health (Lond)

Specialty Gynecology & Obstetrics

Date 2024 Jan 27

PMID 38279825

Authors

Monica L Reynolds

Laura R Loehr

Susan L Hogan

Yichun Hu

Carmen R Isasi

Christina Cordero

Ana C Ricardo

James P Lash

Vimal K Derebail

Affiliations

Soon will be listed here.

Abstract

Background: Hispanic/Latino individuals are less likely to receive optimal treatment for chronic kidney disease than non-Hispanic whites. This may be particularly detrimental for women of reproductive age as chronic kidney disease increases risk for infertility, menstrual irregularities, and pregnancy loss. While these maternal outcomes have been associated with advanced chronic kidney disease, their occurrence in early chronic kidney disease is unclear.

Objectives/design: Using baseline (2008-2011) and second study visit (2014-2017) data from the Hispanic Community Health Study/Study of Latinos, we retrospectively assessed the prevalence of chronic kidney disease as well as the association between chronic kidney disease and self-reported infertility, cessation of menses, hysterectomy, and nonviable pregnancy loss (experienced at less than 24 weeks gestation) in women of reproductive age (18-45 years).

Methods: Multivariable survey logistic regression analyses determined the unadjusted and multivariable-adjusted prevalence odds ratios with 95% confidence intervals between chronic kidney disease and the separate outcomes.

Results: Among 2589 Hispanic/Latino women included (mean age = 31.4 years), 4.6% were considered to have chronic kidney disease. In adjusted analyses, women with chronic kidney disease did not have a significantly increased odds of infertility (odds ratio = 1.02, 95% confidence interval = 0.42-2.49), cessation of menses (odds ratio = 1.25, 95% confidence interval = 0.52-3.04), or hysterectomy (odds ratio = 1.17, 95% confidence interval = 0.61-2.25) compared to those without chronic kidney disease. In those with chronic kidney disease, the adjusted odds of a nonviable pregnancy loss occurring after baseline visit were increased (odds ratio = 2.11, 95% confidence interval = 0.63-7.02) but not statistically significance.

Conclusion: The presence of early stage chronic kidney disease did not confer a significant risk of infertility, cessation of menses, or nonviable pregnancy loss.

References

Holley J, Schmidt R . Changes in fertility and hormone replacement therapy in kidney disease. Adv Chronic Kidney Dis. 2013; 20(3):240-5. DOI: 10.1053/j.ackd.2013.01.003. View

Saran R, Robinson B, Abbott K, Agodoa L, Albertus P, Ayanian J . US Renal Data System 2016 Annual Data Report: Epidemiology of Kidney Disease in the United States. Am J Kidney Dis. 2017; 69(3 Suppl 1):A7-A8. PMC: 6605045. DOI: 10.1053/j.ajkd.2016.12.004. View

Strumpf E, Lang A, Austin N, Derksen S, Bolton J, Brownell M . Prevalence and clinical, social, and health care predictors of miscarriage. BMC Pregnancy Childbirth. 2021; 21(1):185. PMC: 7936485. DOI: 10.1186/s12884-021-03682-z. View

Dumanski S, Ahmed S . Fertility and reproductive care in chronic kidney disease. J Nephrol. 2019; 32(1):39-50. DOI: 10.1007/s40620-018-00569-9. View

Williams D, Davison J . Chronic kidney disease in pregnancy. BMJ. 2008; 336(7637):211-5. PMC: 2213870. DOI: 10.1136/bmj.39406.652986.BE. View

Ricardo A, Flessner M, Eckfeldt J, Eggers P, Franceschini N, Go A . Prevalence and Correlates of CKD in Hispanics/Latinos in the United States. Clin J Am Soc Nephrol. 2015; 10(10):1757-66. PMC: 4594064. DOI: 10.2215/CJN.02020215. View

Wang X, Chen C, Wang L, Chen D, Guang W, French J . Conception, early pregnancy loss, and time to clinical pregnancy: a population-based prospective study. Fertil Steril. 2003; 79(3):577-84. DOI: 10.1016/s0015-0282(02)04694-0. View

Palmer B, Clegg D . Gonadal dysfunction in chronic kidney disease. Rev Endocr Metab Disord. 2016; 18(1):117-130. DOI: 10.1007/s11154-016-9385-9. View

Jesudason S, Grace B, McDonald S . Pregnancy outcomes according to dialysis commencing before or after conception in women with ESRD. Clin J Am Soc Nephrol. 2013; 9(1):143-9. PMC: 3878697. DOI: 10.2215/CJN.03560413. View

10.

Horn J, Tanz L, Stuart J, Markovitz A, Skurnik G, Rimm E . Early or late pregnancy loss and development of clinical cardiovascular disease risk factors: a prospective cohort study. BJOG. 2018; 126(1):33-42. PMC: 6294683. DOI: 10.1111/1471-0528.15452. View

11.

Chang D, Dumanski S, Brennand E, Ruzycki S, Ramage K, Gantar T . Female Reproductive Health and Contraception Use in CKD: An International Mixed-Methods Study. Kidney Med. 2023; 5(10):100713. PMC: 10502408. DOI: 10.1016/j.xkme.2023.100713. View

12.

Hemmelgarn B, Manns B, Lloyd A, James M, Klarenbach S, Quinn R . Relation between kidney function, proteinuria, and adverse outcomes. JAMA. 2010; 303(5):423-9. DOI: 10.1001/jama.2010.39. View

13.

Muka T, Oliver-Williams C, Kunutsor S, Laven J, Fauser B, Chowdhury R . Association of Age at Onset of Menopause and Time Since Onset of Menopause With Cardiovascular Outcomes, Intermediate Vascular Traits, and All-Cause Mortality: A Systematic Review and Meta-analysis. JAMA Cardiol. 2016; 1(7):767-776. DOI: 10.1001/jamacardio.2016.2415. View

14.

Germain A, Romanik M, Guerra I, Solari S, Reyes M, Johnson R . Endothelial dysfunction: a link among preeclampsia, recurrent pregnancy loss, and future cardiovascular events?. Hypertension. 2006; 49(1):90-5. DOI: 10.1161/01.HYP.0000251522.18094.d4. View

15.

Chang D, Dumanski S, Ahmed S . Female Reproductive and Gynecologic Considerations in Chronic Kidney Disease: Adolescence and Young Adulthood. Kidney Int Rep. 2022; 7(2):152-164. PMC: 8820991. DOI: 10.1016/j.ekir.2021.11.003. View

16.

Broughton D, Moley K . Obesity and female infertility: potential mediators of obesity's impact. Fertil Steril. 2017; 107(4):840-847. DOI: 10.1016/j.fertnstert.2017.01.017. View

17.

Cheung K, Stefanick M, Allison M, LeBlanc E, Vitolins M, Shara N . Menopausal symptoms in women with chronic kidney disease. Menopause. 2015; 22(9):1006-11. PMC: 4515400. DOI: 10.1097/GME.0000000000000416. View

18.

Rossen L, Ahrens K, Branum A . Trends in Risk of Pregnancy Loss Among US Women, 1990-2011. Paediatr Perinat Epidemiol. 2017; 32(1):19-29. PMC: 5771868. DOI: 10.1111/ppe.12417. View

19.

Asamiya Y, Otsubo S, Matsuda Y, Kimata N, Kikuchi K, Miwa N . The importance of low blood urea nitrogen levels in pregnant patients undergoing hemodialysis to optimize birth weight and gestational age. Kidney Int. 2009; 75(11):1217-1222. DOI: 10.1038/ki.2009.48. View

20.

Josephson M, McKay D . Women and transplantation: fertility, sexuality, pregnancy, contraception. Adv Chronic Kidney Dis. 2013; 20(5):433-40. DOI: 10.1053/j.ackd.2013.06.005. View