Chronic renal disease and antenatal care

In 2018, it is unusual for women with chronic kidney disease (CKD) to be told that pregnancy is not an option. Maternal and foetal outcomes have steadily improved over the last 50 years and a successful pregnancy, resulting in a healthy infant without detrimental to maternal health, is commonplace. Nevertheless, the incidence of adverse outcomes including pre-eclampsia, preterm birth and small-for-gestational age infants is higher for women with CKD than the general population, requiring enhanced monitoring. Furthermore, as women with more advanced renal disease including dialysis recipients are supported in contemplating pregnancy, the importance of an experienced multidisciplinary team (MDT) has become crucial. Pre-pregnancy planning underpins optimisation of pregnancy outcomes.