Kidney Disease

 

How common is kidney disease in pregnancy?

Approximately 1% of pregnant women have chronic kidney disease.  Women usually know they have a kidney problem before they become pregnant.

There are many causes of chronic kidney disease including diabetes, high blood pressure, lupus and other auto-immune conditions.  Increasingly, women who have undergone a successful kidney transplant are also becoming pregnant.

 

 

How will my kidney disease affect my pregnancy?

Women with kidney disease or a kidney transplant are at higher risk of complications during pregnancy.  Pre-eclampsia, premature birth and fetal growth restriction are all more common.

In general, your risk of pregnancy complications is related to how good or bad your kidney function is at the time of conception.

 

Can pregnancy make my kidney function worse?

Women who have moderate or severely impaired kidney function need to consider the risks of a pregnancy carefully.  Pregnancy can cause your kidney function to deteriorate and this can be permanent.

However, women who only have mild kidney impairment do not usually sustain long-term damage from pregnancy.

 

How should I approach pregnancy?

I advise all women with kidney disease to have a pre-pregnancy assessment by their renal physician and a Maternal-Fetal Medicine Specialist This gives you an opportunity to discuss the potential risks and make a plan for the safest possible pregnancy.

You may also need to adjust your medications.  Several common blood-pressure medications are linked to fetal abnormalities.  So are some of the anti-rejection drugs taken by transplant patients.  It’s essential to change over to a pregnancy-friendly regime before you start trying to conceive.

During pregnancy, regular assessments of fetal growth and kidney function are important.  You need to see an obstetrician experienced in high-risk pregnancy.  In particular, women with moderate / severe kidney impairment and women with kidney transplants should see a Maternal-Fetal Medicine Obstetrician for antenatal care.