Studies in 2022 have advanced knowledge of pregnancy outcomes in kidney donors and transplant recipients as well as the long-term risks associated with hypertensive disorders of pregnancy. These findings should be used to support shared decision-making and appropriate care of women with or at risk of kidney disease.
Key advances
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Living kidney donors have a low absolute risk of adverse pregnancy events4; discussion of risk should be individualized and desire for future pregnancy should not be a barrier to donation.
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Pre-donation pregnancy complications were not associated with increased cardiovascular risk or reduced long-term kidney function in kidney donors; however, donors should receive ongoing follow-up for kidney disease, hypertension and diabetes5.
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In the general population, hypertensive disorders of pregnancy conferred a 2–3-fold increased risk of incident chronic kidney disease that was observed within 3 years of delivery and exacerbated by racial and sociodemographic factors6.
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Pregnancy after kidney transplantation can be complicated but has a high likelihood of excellent outcomes; preconception kidney function is the main driver of pregnancy outcomes and graft loss7.
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Acknowledgements
E.H. (Co-investigator) is supported by the Hospital Research Foundation 2021 Women’s Health Grant awarded to S.J. (Chief Investigator).
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Hewawasam, E., Jesudason, S. Insights into the impact of pregnancy on kidney disease. Nat Rev Nephrol 19, 79–80 (2023). https://doi.org/10.1038/s41581-022-00663-z
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DOI: https://doi.org/10.1038/s41581-022-00663-z
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