The Kidney Foundation of Canada


Dr. Ziv Harel

St. Michael's Hospital, ON

Assessing kidney disease and its outcomes in pregnancy

Co-applicant(s): Joel G. Ray

2018-2020:  $61,344 |  Biomedical Research Grants  |  Category: Screening and prevention of renal disease

Lay Summary

Pregnancy is marked by dramatic changes in kidney function, especially by the amount of blood filtered by the kidneys to make urine – called the “glomerular filtration rate” (GFR). GFR can be measured by a woman’s serum creatinine (SCr), her estimated glomerular filtration rate (eGFR), or her estimated creatinine clearance (CrCl). However, which of these measurements is most accurate in pregnancy is unknown. Pre-existing or acquired kidney injury in pregnancy can lead to poor outcomes for mother and fetus, including maternal preeclampsia and newborn prematurity. Currently, it is not well-established what changes in SCr, eGFR, and CrCl are associated with such poor outcomes. The first goal of this study is to establish “normal” and “abnormal” metrics for these three markers of kidney function in pregnancy among a large proportion of pregnant women in Ontario. Second, based on this new information we will determine which of the three markers, when abnormal, is most associated with poor outcomes among mother and fetus/newborn. We will use these “big data” metrics to help doctors better: detect kidney injury in early, middle and late pregnancy; enable affected women and their fetuses to have better surveillance; use preventive medications like aspirin; and improve decision-making about the optimal timing of delivery.