Call Girls Nagpur Just Call 9907093804 Top Class Call Girl Service Available
Preeclampsia and the Risk of ESRD (Journal Club)
1. Raj Kiran Medapalli, MD, MPH. Nephrology Fellow October 1st, 2008 Mount Sinai School of Medicine Division of Nephrology Journal Club
2. Preeclampsia and the Risk of ESRD Vikse et al. N Engl J Med. 2008 Aug 21;359(8):800-9.
3.
4.
5.
6. Risk factors for pre-eclampsia at antenatal booking: systematic review of controlled studies. Duckitt K and Harrington D. BMJ. 2005 Mar 12;330(7491):565. (38 cohort studies published between 1966 and 2002)
7.
8.
9.
10.
11.
12.
13.
14. Suggested Pathophysiology of Preeclampsia Reference: Parikh, SM & Karumanchi, SA. Putting Pressure on Pre-eclampsia. Nat Med 14 (8), 810-812 (2008)
15. Glomerular Endotheliosis Swelling of damaged endothelial cells, leads to partial closure of many of the capillary lumens (large arrows). Mitosis within an endothelial cell (small arrow) is a sign of cellular repair.
16.
17. Preeclampsia and risk of HTN Reference: Bellamy et al. Pre-eclampsia and risk of cardiovascular disease and cancer later in life: systematic review and metaanalysis. BMJ 2007;335;974.
18. Preeclampsia and risk of CVD Reference: Bellamy et al. Pre-eclampsia and risk of cardiovascular disease and cancer later in life: sytematic review and metaanalysis. BMJ 2007;335;974.
19. Preeclampsia and risk of Stroke and DVT. Reference: Bellamy et al. Pre-eclampsia and risk of cardiovascular disease and cancer later in life: sytematic review and metaanalysis. BMJ 2007;335;974.
20.
21. Preeclampsia and long term mortality Reference: Irgens et al. Long term mortality of mothers and fathers after preeclampsia: population based cohort study. BMJ. 2001 Nov 24;323(7323):1213-7 .
22. Preeclampsia and long term mortality Reference: Irgens et al. Long term mortality of mothers and fathers after preeclampsia: population based cohort study. BMJ. 2001 Nov 24;323(7323):1213-7 .
23.
24. Persistent Endothelial Dysfunction 5-6 yrs after Preeclampsia Reference: Chambers et al. Association of maternal endothelial dysfunction with preeclampsia. JAMA. 2001 Mar 28;285(12):1607-12.
25.
26. Persistant microalbuminuria after preeclampsia Reference: Bar et al. Microalbuminuria after pregnancy complicaed by preeclampsia. Nephrol Dial Transplant (1999) 14:1129-1132.
27.
28. Preeclampsia and risk of having a kidney biopsy later in life Reference: Vikse et al. Adverse perinatal outcome and later kidney biopsy in the mother. J Am Soc Nephrol. 2006 Mar;17(3):837-45.
29. Preeclampsia and risk of having a kidney biopsy later in life Reference: Vikse et al. Adverse perinatal outcome and later kidney biopsy in the mother. J Am Soc Nephrol. 2006 Mar;17(3):837-45.
30. Preeclampsia and the Risk of ESRD Vikse et al. N Engl J Med. 2008 Aug 21;359(8):800-9.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40. 1980 1973 1970 1967 2005 P#1 P#2 3 yrs 7 yrs 25 yrs 1980 1973 1970 1967 1990 2005 P#1 P#2 ESRD/Death 3 yrs 7 yrs 10 yrs Example 1 : No ESRD or Death during the study period (1967 to 2005) Total Time included in the study = 7 + 25 = 32 years Example 2: ESRD or Death in 1990 Total time included in the study: 7 + 10 = 17 years
41. 1980 1973 1970 1967 2005 P#1 P#2 1980 1973 1970 1967 1976 2005 P#1 P#2 Death Example 3 : ESRD in 1976 Total Time included in the study =??? It is not clear if this patient would be registered in the Renal Registry or not. Example 4: Death in 1976 Total time included in the study: ??? Authors did not specify in the methods section how they dealt with these pts 1976 ESRD
I-squared, is a measure of heterogeneity among individual studies that cannot be explained by chance. It ranges between 0% and 100% with lower values representing less heterogeneity, with values of 25%, 50%, and 75% representing low, moderate, and high heterogeneity.
In this metanalyses by Bellamy et al, 25 prospective and retrospective cohort studies, published between 1960 and 2006 were included, providing a dataset of 3,488,160 women, with 198,252 affected by pre-eclampsia (exposure group) and 29,495 episodes of cardiovascular disease and cancer (study outcomes).