Renal disease in pregnancy

The incidence of acute renal failure in South Africa has been reduced and is a reflection of improved obstetric care. A report of eclampsia in the UK suggests that eclampsia with its attendant risk of acute renal failure may never be eliminated completely. There has been progress in understanding the changes in endothelial cell metabolism and pre-eclampsia but there has been limited success in improving treatment. The development of hypertension or pre-eclampsia during pregnancy may predict the development of hypertension, but it rarely indicates underlying renal disease. It appears that pregnancy does not adversely affect the course of renal disease if renal function is normal at conception, but it may hasten the decline in renal function in women who have impaired renal function at conception. The frequency of complication both for mother and for child remain high in such pregnancies.