Pregnancy in women with underlying renal disease
- Phyllis August, MD, MPH
Phyllis August, MD, MPH
- Ralph A Baer, MD Professor of Research in Medicine
- Director, Hypertension Center
- Division of Nephrology & Hypertension
- Weill Cornell Medical College
- John Vella, MD, FACP, FRCP, FASN
John Vella, MD, FACP, FRCP, FASN
- Associate Professor of Medicine
- Tufts University School of Medicine
- Section Editors
- Charles J Lockwood, MD, MHCM
Charles J Lockwood, MD, MHCM
- Section Editor — Obstetrics
- Senior Vice President, USF Health
- Dean, Morsani College of Medicine
- Professor, Obstetrics and Gynecology
- University of South Florida
- Gary C Curhan, MD, ScD
Gary C Curhan, MD, ScD
- Section Editor — Chronic Kidney Disease
- Editor-in-Chief emeritus
- Harvard Medical School
There are two questions that need to be addressed when a woman with underlying kidney disease becomes pregnant:
●What is the effect of pregnancy on the kidney disease?
●What is the effect of the kidney disease on pregnancy?
A review of issues relating to pregnancy in women with diabetic nephropathy is presented separately. (See "Pregnancy in women with diabetic kidney disease" and "Pregestational diabetes: Preconception counseling, evaluation, and management".)
EFFECT OF PREGNANCY ON KIDNEY DISEASE
When considering the effect of pregnancy on kidney disease, it is important to distinguish between changes in clinical manifestations and possible alterations in the long-term course of the disease. Proteinuria increases in approximately one-half of cases, and hypertension develops or worsens in approximately one-quarter of cases [1-6]. Severe hypertension can occur, potentially leading to maternal injury, premature delivery, or poor fetal outcome . Marked worsening of edema also can be seen in women with the nephrotic syndrome. These changes generally resolve after delivery.
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- EFFECT OF PREGNANCY ON KIDNEY DISEASE
- Effect on renal function
- Lupus nephritis
- Kidney biopsy during pregnancy
- EFFECT OF KIDNEY DISEASE ON PREGNANCY
- Pregnancy in mild to moderate chronic kidney disease
- - Drug therapy
- Pregnancy in the dialysis patient
- Pregnancy in the renal transplant recipient
- - Cyclosporine
- - Mycophenolate mofetil
- - Sirolimus
- - Tacrolimus
- - Glucocorticoids
- Male fertility after transplantation
- - Evaluation of renal dysfunction
- OBSTETRICAL MANAGEMENT OF WOMEN WITH UNDERLYING RENAL DISEASE
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS