Chronic Kidney Disease in Pregnancy

Abstract

Irrespective of the etiology of underlying chronic kidney disease (CKD), there appears to be an association between maternal/fetal outcomes and the degree of underlying renal insufficiency. Maladaptation to pregnancy predisposes pregnant women with moderate to severe renal insufficiency to the risk of progressive decline in renal function that can be irreversible, a risk that is unique to this population. Fertility rates decline with severity of renal failure. Conception is relatively rare in women on dialysis. Fetal survival has improved by almost 25% per decade in pregnant dialysis patients, reaching over 85% in patients receiving nocturnal hemodialysis. Available evidence points to better outcomes with longer dialysis sessions.