Chronic Kidney Disease and Pregnancy

Area of Science:

• Nephrology
• Obstetrics
• Perinatology

Background:

• Chronic kidney disease (CKD) encompasses diverse kidney disorders affecting structure and function.
• CKD significantly elevates risks for adverse maternal and perinatal outcomes, escalating with renal dysfunction severity, proteinuria, and hypertension.
• Pregnancy can exacerbate kidney disease, potentially causing renal function decline, especially with concurrent hypertension and proteinuria.

Purpose of the Study:

• To review the impact of chronic kidney disease on pregnancy outcomes.
• To outline strategies for optimizing maternal and neonatal health in pregnant individuals with CKD.
• To emphasize the importance of multidisciplinary care and collaboration.

Main Methods:

• Literature review focusing on the effects of CKD on pregnancy.
• Analysis of physiological changes during pregnancy in women with CKD.
• Synthesis of current clinical recommendations for managing pregnant patients with CKD.

Main Results:

• CKD, even mild, is linked to increased risks of preeclampsia, preterm birth, and small-for-gestational age neonates.
• Physiological adaptations in pregnancy can complicate CKD diagnosis and management.
• Adverse outcomes are more frequent with greater CKD severity, proteinuria, and hypertension.

Conclusions:

• Optimizing pregnancy outcomes requires meticulous management of hypertension and proteinuria, alongside preeclampsia prevention strategies like aspirin.
• Avoiding nephrotoxic/teratogenic medications and considering renal dosing are essential.
• Multidisciplinary team collaboration, including obstetricians and nephrologists, is vital for comprehensive care and improved maternal-fetal outcomes.