Update on Pregnancy in Chronic Kidney Disease

The occurrence of pregnancy in patients with chronic kidney disease (CKD) has been considered a dangerous event both for the mother and for the fetus. However, increasing evidence shows that the stage of CKD is the leading factor that can predict possible acceleration in the declining of renal function and complications of pregnancy. This review summarizes recent data on pregnancy in patients with CKD, dialysis and kidney transplantation. Copyright © 2011 S. Karger AG, Basel Discovery of Renal Dysfunction during Pregnancy Pregnancy is probably the major physiologic event that can induce profound changes in renal function. The glomerular filtration rate (GFR) as well as the local production of erythropoietin and vitamin D [1, 2] increase by more than 50%. The increase in GFR is due to an augmented renal blood flow, not to an increased intraglomerular pressure [3] . However, in the presence of chronic kidney disease (CKD), this physiological adaptation is reduced or absent [1] . Therefore, a woman with undiagnosed renal dysfunction might present the first symptoms and signs during pregnancy. Published online: June 21, 2011 Prof. Loreto Gesualdo Nephrology, Dialysis and Transplantation Unit University of Bari, Policlinico, Piazza Giulio Cesare 11 IT–70124 Bari (Italy) E-Mail l.gesualdo @ nephro.uniba.it © 2011 S. Karger AG, Basel 1420–4096/11/0344–0253$38.00/0 Accessible online at: www.karger.com/kbr D ow nl oa de d by : 54 .7 0. 40 .1 1 11 /2 3/ 20 17 7 :0 9: 09 P M