Pregnancy in Chronic Kidney Disease: questions and answers in a changing panorama

Publication date: July 2015 Source:Best Practice & Research Clinical Obstetrics & Gynaecology, Volume 29, Issue 5 Author(s): Giorgina Barbara Piccoli , Gianfranca Cabiddu , Rossella Attini , Federica Vigotti , Federica Fassio , Alessandro Rolfo , Domenica Giuffrida , Antonello Pani , Piero Gaglioti , Tullia Todros Chronic kidney disease (CKD) is increasingly encountered in pregnancy because of greater diagnostic awareness, which is a reflection of the newer, broader definitions (i.e., any changes in blood or urine composition or at imaging, or a glomerular filtration rate (GFR) of <60 mL/min lasting at least 3 months) and of increased incidence (higher maternal age and better outcomes of several kidney diseases). CKD is extremely heterogeneous and may be described by the degree of GFR reduction (CKD stages), the presence of proteinuria and hypertension and the type of kidney disease; the risk of adverse pregnancy-related events increases as GFR decreases and it is affected by proteinuria and hypertension. Specific risks are reported in various diseases such as lupus nephropathy or diabetic nephropathy. While transplantation at least partially restores fertility in end-stage kidney disease, pregnancy on dialysis is increasingly reported. This chapter deals with the available evidence on the management of CKD patients in pregnancy.
Source: Best Practice and Research Clinical Obstetrics and Gynaecology - Category: OBGYN Source Type: research