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Management of Autosomal Dominant Polycystic Kidney Disease (ADPKD) During Pregnancy: Risks and Challenges

Lucy McBride1, Catherine Wilkinson2, Shilpanjali Jesudason2,3

  • 1Women's and Babies' Division, Women's and Children's Hospital, Adelaide, SA, Australia.

International Journal of Women'S Health
|June 18, 2020
PubMed

Insights

Autosomal dominant polycystic kidney disease (ADPKD) impacts many, causing kidney cysts and function loss. Managing ADPKD in pregnancy presents challenges for optimal maternal and fetal outcomes.

Area of Science:

  • Nephrology
  • Genetics
  • Reproductive Medicine

Background:

  • Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder affecting 1 in 1000 individuals.
  • It is characterized by progressive renal cyst development, leading to kidney function decline and potential extra-renal manifestations like hepatic cysts and intracranial aneurysms.
  • Pathogenic variants in the PKD1 or PKD2 genes are the primary cause of ADPKD.

Purpose of the Study:

  • To review the advancements in ADPKD management, including genetic testing and novel therapeutics.
  • To highlight the complexities and risks associated with renal disease in pregnancy for women with ADPKD.
  • To outline the challenges faced by women with ADPKD and healthcare providers in optimizing care across pre-pregnancy, pregnancy, and postpartum periods.

Main Methods:

  • Literature review of recent advancements in ADPKD diagnosis and treatment.
  • Analysis of the impact of ADPKD on pregnancy outcomes.
  • Discussion of clinical management strategies for pregnant women with ADPKD.

Main Results:

  • Genetic testing and pre-implantation genetic diagnosis have improved ADPKD management.
  • New therapeutic agents offer potential for better disease control.
  • Pregnancy in women with ADPKD poses significant risks for both mother and fetus.

Conclusions:

  • Modern advancements in ADPKD management offer new hope for patients.
  • Careful planning and multidisciplinary management are crucial for pregnant women with ADPKD.
  • Addressing the challenges in pre-pregnancy, pregnancy, and postpartum care is essential for improving outcomes.

Keywords:
autosomal dominant polycystic kidney diseasechronic kidney diseasecystic kidney diseasepregnancy

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