Renal Disorders in Pregnancy: Core Curriculum 2019

Maria L. Gonzalez Suarez, Andrea Kattah, Joseph P. Grande, Vesna Garovic

Research output: Contribution to journalReview articlepeer-review

13 Scopus citations

Abstract

As the incidence of chronic kidney disease increases and women pursue pregnancy at more advanced ages, the management of kidney disease in pregnancy has become increasingly relevant to the practicing nephrologist. Women with kidney disorders face several challenges in pregnancy due to increased physiologic demands on the kidney and risk for disease progression, the potential teratogenicity of medications, and the increased risk for complications such as preeclampsia and preterm delivery. Challenges posed by an underlying disease process in pregnancy, such as autoimmune disease or diabetes mellitus, necessitate an interdisciplinary team to ensure good maternal and fetal outcomes. Rates of acute kidney injury in pregnancy are generally declining worldwide, but remain a significant public health concern in developing countries. Pregnancy may also be the first time that a woman has kidney disease or hypertension diagnosed. An understanding of what constitutes normal physiologic changes in pregnancy is critical in a diagnostic evaluation. In this review, we review physiologic changes in pregnancy, causes and management of acute kidney injury in pregnancy, hypertensive disorders of pregnancy, and how to care for women with chronic kidney disease of various causes, including the use of antihypertensives and immunosuppressants.

Original languageEnglish (US)
Pages (from-to)119-130
Number of pages12
JournalAmerican Journal of Kidney Diseases
Volume73
Issue number1
DOIs
StatePublished - Jan 2019

Keywords

  • Pregnancy
  • acute kidney injury (AKI)
  • autoimmune disease
  • chronic kidney disease (CKD)
  • diabetes mellitus
  • dialysis
  • hypertension
  • immunosuppression
  • kidney transplantation
  • maternal fetal complications
  • preeclampsia
  • renal disease
  • renal outcomes
  • review

ASJC Scopus subject areas

  • Nephrology

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