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Pregnancy in Kidney Disease

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Endocrine Disorders in Kidney Disease

Abstract

Pregnancy rates in women with chronic kidney disease (CKD) are increasing even in those with end-stage kidney disease (ESKD) maintained on renal replacement therapy. Pregnancies in this population can result in a variety of maternal and fetal complications, but outcomes have improved over the last 50 years. The effect of pregnancy on progression of CKD is likely minimal in those with early stages of CKD but can be a significant concern in those with CKD stages 3–5. Hypertension and proteinuria are common maternal complications, and preeclampsia, a challenge to diagnose, has been reported to occur in as many as 19% of cases. In more advanced stages of CKD, fetal complications commonly include preterm delivery, intrauterine growth retardation, and reduced infant survival. These complications have recently been noted to be in decline with recent reports confirming improved fetal outcomes and no significant increases in maternal mortality. Improved management of comorbidities such as hypertension, intensified dialysis in women with ESKD, and close to attention to management of CKD-associated complications such as volume control and nutrition, anemia, and mineral-bone disease factors is an important advance that likely is associated with these improved outcomes. These issues are discussed in detail in this chapter.

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Authors and Affiliations

  1. Division of Nephrology and Hypertension, University of California Irvine School of Medicine, Orange, CA, USA

    Madeleine V. Pahl

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  1. Madeleine V. Pahl
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Correspondence to Madeleine V. Pahl .

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Editors and Affiliations

  1. Division of Nephrology and Hypertension, Departments of Medicine and Public Health, University of California Irvine, School of Medicine, Orange, CA, USA

    Connie M. Rhee

  2. Division of Nephrology and Hypertension, Departments of Medicine, Pediatrics, Public Health, and Nursing Sciences, University of California Irvine, School of Medicine, Orange, CA, USA

    Kamyar Kalantar-Zadeh

  3. Division of Endocrinology, Diabetes, and Hypertension, Departments of Medicine and Physiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA

    Gregory A. Brent

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Pahl, M.V. (2019). Pregnancy in Kidney Disease. In: Rhee, C., Kalantar-Zadeh, K., Brent, G. (eds) Endocrine Disorders in Kidney Disease. Springer, Cham. https://doi.org/10.1007/978-3-319-97765-2_11

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  • DOI: https://doi.org/10.1007/978-3-319-97765-2_11

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