MO162IMPACT OF THE IMMUNOSUPPRESSIVE TREATMENT, X-RAY EXPOSITION AND RENAL PATHOLOGY ON OVARIAN RESERVE IN YOUNG WOMEN
| Autor: | Małgorzata Król, Krajewska Magdalena, Ciszewska Anna, Augustyniak-Bartosik Hanna, Oktawia Mazanowska, Maciej Kanafa, Mariusz Kusztal, Andrzej Tukiendorf, Kościelska-Kasprzak Katarzyna, Rasała Julia |
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| Rok vydání: | 2021 |
| Předmět: |
Immunosuppressive treatment
Transplantation medicine.medical_specialty Kidney business.industry Signs and symptoms Gastroenterology medicine.anatomical_structure Renal pathology Nephrology Internal medicine medicine Ovarian reserve business Diagnostic radiologic examination Hormone Exposition (narrative) |
| Zdroj: | Nephrology Dialysis Transplantation. 36 |
| ISSN: | 1460-2385 0931-0509 |
| DOI: | 10.1093/ndt/gfab092.0040 |
| Popis: | Background and Aims Cyclophosphamide treatment and X-ray exposition in the area of the ovaries are proven to be the gonadotoxic factors in childbearing age women. Anti-Müllerian hormone (AMH) is regarded as a biomarker for ovarian reserve. Method The study included 167 consecutive premenopausal women attending Nephrology Clinic who gave informed consent and met exclusion criteria (past ovarian surgical procedure, PCOS, eGFR Statistical analysis included both regressive and non-regressive relationships between the studied clinical features. Due to the presumption of the remaining non-regression relationships between clinical factors, an original taxonomic method by Marczewski & Steinhaus was used instead of general linear modeling. Based on patient age, eGFR, renal pathology an ‘optimal’ segregation of patients was performed following the created classification tree (dendrogram). Results Median age of the patients was 33 (range 18-44). Median AMH concentration was 2,66 ng/ml; AMH levels were classified in 64 females as low (median 1,015) and in 103 as normal/above age-adjusted reference (median 4,04). Sixty one patients were treated with cyclophosphamide in the past and 45 underwent kidney transplantation. 92 women suffered from glomerulonephritis, 44 from lupus nephritis, 12 from interstitial kidney disease, 5 from ADPKD and 14 from other kidney diseases. Age, eGFR, pregnancies in the past as well as being the kidney transplant recipient were the coefficients strongly correlated with AMH level. Presence of lupus nephritis was correlated with lower levels of AMH in comparison to other renal diseases and in contrast to cyclophosphamide. X-ray exposition measured in cumulative lifetime dose was not correlated with AMH levels. Conclusion Although previous researchers suggested cyclophosphamide to be the strong gonadotoxic factor, our statistical analysis approach shows that lupus as the disease often treated with cyclophosphamide may be the lowering ovarian reserve factor itself. Further studies on this subject are still necessary. |
| Databáze: | OpenAIRE |
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