renal disease in pregnancy

Pregnancy results in important alterations in acid-base, electrolyte, and renal function due to pregnancy-associated physiologic changes in renal and systemic hemodynamics.
Understanding these changes is essential when evaluating pregnant women with renal disease.

Disorders that cause acute kidney injury in early or late pregnancy generally fall into very different categories, and it must also be remembered that pregnancies in women with underlying chronic kidney disease who require dialysis during pregnancy or who have previously undergone renal transplantation pose unique sets of issues.

Understanding the physiologic changes and disorders that occur in women with renal disease in pregnancy forms the basis of appropriate management of these unusual disorders.

Ideally, women with kidney disease or systemic diseases that would put them at risk during pregnancy should receive preconception counseling from physicians knowledgeable about the current literature related to pregnancy. Successful maternal and fetal outcomes for women with preexisting kidney disease, and those with onset of kidney disease during pregnancy, require a close working relationship among all physicians involved in the care of these patients.