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Pregnancy and the Kidney

Women with renal disease wishing to conceive or already pregnant seek our advice as to whether the pregnancy will be complicated, the baby will be healthy, and if gestation will further damage their kidneys. Similar queries come from renal allograft recipients. Most gestations succeed and there is little or no evidence that pregnancy adversely influences the natural history of the disease or transplant, provided that renal function is preserved, or but minimally decreased, and hypertension absent. The presentation which follows starts with a synopsis of changes in the urinary tract ocurrng in normal gestation, focusing on their relevance to clinical circumstance. The lecture then stresses gestation in women with chronic disease of the kidney including those receiving renal replacement therapy. There are also brief discussions of acute renal failure (ARF) and when to perform a renal biopsy during pregnancy


A. Morphological changes

1. Kidney weight and size increase, mainly due to increments in interstitial and

2. The most striking morphological changes, however, occur in the collecting

4. Relevance of these changes

2. The relevance of these changes is that concentrations of serum creatinine,

II. Pregnancy in Women With Preexisting Disease (SEE