ABSTRACT
Debido a los beneficios potenciales del estrógeno en la función renal, los investigadores estudiaron si las mujeres que se someten a ooforectomía bilateral podrían tener un mayor riesgo de enfermedad renal crónica (ERC). Realizaron un estudio de cohortes basado en la población de 1.653 mujeres que se sometieron a ooforectomía bilateral desde 1988 hasta 2007, cuando tenían menos de 50 años, y antes del inicio de la menopausia.
Because of the potential benefits of estrogen in kidney function, the researchers studied whether women who undergo bilateral oophorectomy might have an increased risk of chronic kidney disease (CKD). They conducted a cohort study based on the population of 1,653 women who underwent bilateral oophorectomy from 1988 to 2007, when they were less than 50 years old, and before the onset of menopause.
Subject(s)
Female , Premenopause , Ovariectomy , Renal Insufficiency, ChronicABSTRACT
BACKGROUND AND OBJECTIVES: Pregnancies in women with systemic lupus erythematosus (SLE) and lupus nephritis are considered high-risk due to high rates of maternal and fetal complications. However, there has not been a formal analysis addressing the issue of maternal deaths in these women. The aim of this study was to perform a literature review of the maternal deaths in women with SLE and lupus nephritis to: (1) identify the main causes of death and (2) discuss possible reasons for these causes, and strategies that may improve patient care and outcomes. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENT: We performed an extensive electronic literature search from 1962 to 2009 using online databases (PubMed, Embase, Lilacs, Cochrane Controlled Trials Register, Medline, and Science Citation Index). Studies were included if they reported pregnancies in patients with SLE and lupus nephritis with at least one reported maternal death. RESULTS: We identified 13 studies that reported a total of 17 deaths in the 6 week post-partum period that were attributable to SLE and lupus nephritis. In all cases, death occurred in the setting of active disease, and was attributed either to infection in 41.2% (n = 7), or disease activity in 29.4% (n = 5). The remaining deaths were due to pulmonary embolus in 11.8% (n = 2), pregnancy-associated cardiomyopathy in 5.9% (n = 1), adrenal failure due to abrupt steroid withdrawal in 5.9% (n = 1), and undefined in 5.9% (n = 1). CONCLUSIONS: All maternal deaths in patients with SLE and lupus nephritis occurred in those with active disease, with disease activity/complications and infections (mainly opportunistic) being the two major causes. The presented evidence further supports timing of pregnancy relative to SLE activity, and the judicious use of immunosuppressive agents in pregnant patients.
