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Non-postural serial changes in renal function during the third trimester of normal human pregnancy
British Journal of Obstetrics and Gynaecology
|May 1, 1981
Summary
Pregnancy significantly reduces renal plasma flow but not glomerular filtration rate in healthy women. Kidney function changes, including increased plasma creatinine and urate, occur during the third trimester.
Area of Science:
- Obstetrics and Gynecology
- Nephrology
- Physiology
Background:
- Renal function undergoes significant adaptations during pregnancy.
- Understanding these changes is crucial for maternal and fetal health.
- Previous studies have shown variable effects on renal hemodynamics in pregnancy.
Purpose of the Study:
- To investigate changes in renal plasma flow and glomerular filtration rate during the third trimester of normal pregnancy.
- To assess alterations in plasma creatinine and serum urate concentrations and their renal handling.
- To evaluate the impact of pregnancy on key markers of kidney function.
Main Methods:
- Infusion studies were conducted in 17 healthy pregnant women.
- Measurements were taken near the beginning and end of the third trimester.
- Renal plasma flow, glomerular filtration rate (inulin clearance), plasma creatinine, and serum urate were assessed.
Main Results:
- Effective renal plasma flow significantly decreased near the end of the third trimester.
- Glomerular filtration rate (inulin clearance) remained unchanged.
- Plasma creatinine concentration increased significantly, with unchanged renal handling.
- Serum urate concentration increased significantly, attributed to increased tubular reabsorption.
- 24-hour creatinine clearance showed a tendency to decrease.
Conclusions:
- Third-trimester pregnancy is associated with a significant decline in effective renal plasma flow.
- Despite increased plasma creatinine, glomerular filtration rate is maintained.
- Elevated serum urate levels during late pregnancy are likely due to increased renal tubular reabsorption.