OBJECTIVE

Improvement of early diagnosis of chronic kidney disease (CKD), improvement of its quality in case of reduced renal function in pregnant women by means of renal arteries Dopplerometry.

MATERIAL AND METHODS

A total of 283 pregnant women were included in the study. The 1st (control) group included 50 healthy pregnant women and the 2nd (main) group included 233 pregnant women with CKD. Pregnant women were distributed according to the stages of chronic kidney disease taking into account the rate of glomerular filtration into the following subgroups: 2A — stage I CKD (143 patients), 2B — stage II CKD (34 patients), 2C — stage III CKD (45 women), 2D — stage IV CKD (7 pregnant women), 2E — stage V CKD (4 patients). Dopplerometry of renal, segmental, interlobular, and interlobular arteries on both sides was performed at the following gestational periods: before 12 weeks; 13—21, 22—25, 26—28, 29—31, 32—34, 35—37, and 38—40 weeks. The following dopplerometric parameters were analyzed: peak systolic blood flow velocity (PSV), end-diastolic velocity (EDV), pulsatility index (PI), resistance index (IR), systolodiastolic ratio (S/D).

RESULTS

Measurement of peak systolic velocity in the interlobar arteries is the most informative. Pregnant women with CKD showed a decrease in PSV in the renal parenchyma vessels (interlobular vessels) on both sides, starting from stage I of CKD. In II and III trimesters of pregnancy, the separating values (cut-off thresholds) of PSV of the interlobar arteries were derived, with the help of which it was possible to differentiate the absence and presence of CKD in pregnant women in II and III trimesters, and in I, II, III trimesters — to differentiate chronic renal failure (CRF) from I and II stages of CKD.

CONCLUSION

The most informative ultrasound marker of renal dysfunction in pregnant women is the maximum blood flow velocity in the interlobular arteries, which allows to determine the presence of CKD and differentiate CKD from CKD stages I and II.