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Chronic Kidney Disease in Pregnancy

CKD stage, proteinuria, and blood pressure control are the most important determinants of pregnancy outcomes.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Kadın Hastalıkları ve Doğum department. Book Appointment →

What is Chronic Kidney Disease in Pregnancy?

In pregnant women with CKD, the stage of disease, the amount of proteinuria, and blood pressure control determine pregnancy outcomes. Adverse outcomes increase markedly in stage 3 and above CKD; in disease that may require dialysis, transplantation before pregnancy is preferred.

Preconception counseling includes GFR, proteinuria, blood pressure, the underlying disease (lupus nephritis, diabetic nephropathy, FSGS, autosomal dominant polycystic kidney disease), and medication management. ACE inhibitors, ARBs, and MMF are contraindicated in pregnancy.

Monthly or more frequent serum creatinine, spot protein/creatinine ratio, and blood pressure monitoring are recommended; aspirin prophylaxis for preeclampsia is suggested. Fetal monitoring with growth, amniotic fluid, and Doppler studies is routine.

Symptoms

Increasing edema and weight gain
Hypertensive episodes
Increased proteinuria
Rising serum creatinine
Anemia and fatigue
Findings of fetal growth restriction

Risk Factors

Diabetic nephropathy
Lupus nephritis
Autosomal dominant polycystic kidney disease
IgA nephropathy
Chronic pyelonephritis
Pregnancy after renal transplantation

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • For preconception counseling
  • New-onset edema and headache
  • When blood pressure is above target
  • Increased proteinuria or rising serum creatinine

Treatment Methods

01
Multidisciplinary nephrology–MFM follow-up
02
Low-dose aspirin prophylaxis
03
Pregnancy-compatible antihypertensives (labetalol, nifedipine)
04
Strict proteinuria and GFR monitoring
05
Fetal growth and Doppler monitoring
06
Preterm delivery planning

Which Department to Visit?

You can visit our Kadın Hastalıkları ve Doğum department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Kadın Hastalıkları ve Doğum Department

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.