AFLP AKI Delivery — ESENeph MCQ

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HardPregnancy & RenalAFLP AKI DeliveryESENeph

A pregnant woman at 24 weeks has known CKD. Her laboratory report gives creatinine 118 micromol/L and an automatically calculated eGFR of 48 mL/min/1.73m². Which interpretation is correct?

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Correct answer: E — Use the serum creatinine trend to assess renal function

The best answer is “Use the serum creatinine trend to assess renal function”. Renal function in pregnancy is followed with serum creatinine, interpreted against the prepregnancy value and gestational trend. Routine creatinine-based eGFR equations are not valid during pregnancy. “Use the reported eGFR unchanged because pregnancy does not alter creatinine physiology” is less appropriate because gestational hyperfiltration and changing physiology invalidate routine eGFR equations “Stage CKD from the eGFR and disregard the measured creatinine” is less appropriate because the eGFR number should not drive pregnancy assessment when the equation is not validated “Use urine ACR as a substitute measure of filtration” is less appropriate because albuminuria measures kidney damage, not glomerular filtration “Use cystatin C eGFR as a validated pregnancy replacement” is less appropriate because the UK renal-pregnancy guideline recommends serum creatinine rather than an estimating equation

Reference: UK clinical practice guideline on pregnancy and renal disease: https://pmc.ncbi.nlm.nih.gov/articles/PMC6822421/