Table of Contents
Introduction
Kidneys are the major organs in blood filtration and maintaining the body's electrolyte and acid-base balance. Any disease or disorder affecting the kidneys greatly impacts a person's life. It becomes even more complicated when a patient with improperly functioning kidneys gets pregnant. Pregnancy with pre-existing kidney disease is challenging for both the patient and the physician because of the increased complications. During pregnancy, the kidneys will have an increased demand to function properly. Hence, the pregnancy journey in those cases should be guided by a good team of doctors to ensure good health for the mother and the baby.
What Effects Does Pregnancy Have on Kidney Disease?
Pregnancy puts more effort into the kidneys since the body contains additional blood and alternative hormones and requires additional energy.
This leads to,
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Increased Protein in the Urine—The kidneys become fatigued and release excess protein.
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Weaker Kidneys—If your kidneys are already ill, they will worsen quickly.
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High Blood Pressure—Blood pressure may rise, harming the mom and baby.
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Swelling—The body retains excessive water, so hands, feet, or face become puffy.
How much it occurs depends on how well the kidneys were functioning before pregnancy. Doctors have to carefully monitor it to stay safe for both mom and baby.
What Are the Risks of Being Pregnant With Kidney Disease?
Studies report that the incidence of women getting pregnant with pre-existing renal diseases has increased in recent years, with a reported incidence of 15,000 to 20,000 pregnancies per year. The most common cause of chronic kidney disease in those patients is attributed to the fact that women pursue pregnancy at more advanced ages. Although pre-existing kidney disease is not an obstacle to reproduction in women, it is associated with high chances of maternal and fetal complications. Research shows that women under dialysis for more than a year would lose their ability to become pregnant as their menstrual cycle becomes irregular or absent. The most common kidney diseases reported in pregnant women and their babies are discussed below.
Risks to Mother:
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High Blood Pressure—Kidney problems can raise blood pressure, which can be dangerous for both mom and baby.
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Weaker Kidneys—If the kidneys are already sick, pregnancy can worsen them. Some moms might need special treatment like dialysis sooner.
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Too Much Protein in Pee—Sick kidneys can leak extra protein into pee, so they struggle.
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Swelling—The body might hold too much water, making hands, feet, and faces puffy. In bad cases, water can fill the lungs and make breathing hard.
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More Infections—Moms with kidney disease can get more bladder or kidney infections, making them sick.
Doctors watch moms closely to help keep them and their babies safe!
Risks to the Baby:
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Preterm Birth—Most babies are born prematurely, which may lead to breathing and feeding difficulties.
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Low Birth Weight—The babies can be lighter than average as the placenta might not function as efficiently in women with kidney disease.
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Stillbirth—In extreme conditions, there are increased chances of pregnancy loss in case kidney disease is not effectively managed.
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Developmental Delays—Premature or low-birth-weight babies can have health issues as they develop.
Can Kidney Disease in the Mother Affect Fetal Development?
If the pregnant mother has kidney issues or kidney disease, it could indeed affect the health of the unborn baby. Are you planning to have a baby? If so, you should talk to your doctor or other healthcare provider ahead of time to ensure your kidneys are healthy. Kidney disease in a pregnant woman can have a substantial impact on fetal development. It can cause complications like low birth weight, prematurity, growth restriction, and even death of the baby in the womb. This is due to a lower blood supply and nutrient delivery to the baby in the womb.
What Are the Common Complications Seen in Mother and Baby?
Here, we discuss in detail the common complications seen in a woman when she gets pregnant with kidney issues. The common kidney issues and their complications in mother and baby are given below. This will help you understand how to manage these kidney issues during pregnancy.
Hypertension
Women with a known history of hypertension before pregnancy are at increased risk of developing preeclampsia (a condition in which the blood pressure value is more significant than 140/90 mmHg).
Complications:
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Impaired angiogenesis (blood vessel formation) in the fetus.
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Seizures may develop in mothers in cases of uncontrolled hypertension.
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Fetal death.
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Preterm delivery.
Management:
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Reduce the salt intake.
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Use of antihypertensives (to control blood pressure levels).
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Emergency C-sections.
Lupus Nephritis
The occurrence of systemic lupus erythematosus (SLE) in the kidney is called lupus nephritis. Women with a known history of lupus nephritis should take advice from their physician before conception, and they should have at least a six-month quiescent period before pregnancy.
Complications:
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High risk of preterm delivery.
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High chances of developing preeclampsia.
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The estimated overall mortality rate is one percent.
Management:
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Patients should be monitored carefully to diagnose any disease flares.
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Drugs such as Hydroxychloroquinone and Azathioprine can be used to suppress the autoantibodies.
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Renal function tests and biomarker tests.
IgA Nephropathy
The deposition of IgA antibodies in the kidney characterizes IgA nephropathy. It affects normal kidney function.
Complications:
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Early delivery.
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Pregnancy loss.
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Preeclampsia.
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Low-birth-weight babies.
Management:
Patients usually do not require treatment. Safer immunosuppressive agents should be prescribed for patients with severe disease conditions.
Chronic Kidney Disease
Chronic kidney disease is characterized by the improper functioning of the kidneys, which lasts for a longer period.
Complications:
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Decreased renal function.
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Preterm delivery.
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HELLP syndrome (a serious complication of pregnancy). It mainly affects the blood and the liver.
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Stillbirths.
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Neonatal death.
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Low birth weight.
Management:
The patient should be informed before the complications of pregnancy with the pre-existing renal disease. Careful monitoring and neonatal care would help improve the survival rates.
End-Stage Renal Disease (ESRD)
Pregnant women with end-stage renal disease require dialysis.
Complications:
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High mortality rates.
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Fetal death.
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Early delivery.
Management:
The main aim of treatment is to treat the underlying disease to prevent the further progression of renal disease. The patient should be informed before pregnancy complications with pre-existing renal disease occur.
How to Manage Kidney Function After Giving Birth?
Post-delivery, the management of kidney function is very important for the health of a mother, particularly for patients with pre-eclampsia or renal complications. Regular monitoring can help identify issues early.
Key steps include:
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Checking blood pressure, urine protein, and serum creatinine at regular intervals.
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Visiting a healthcare professional for medication and fluid management.
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Adhering to a well-organized care plan with a medical team.
Conclusion
Pregnancy in the presence of preexisting kidney disease may be difficult and dangerous for both the mother and the baby. It has a greater risk of complications such as high blood pressure, preterm delivery, low birth weight, and even stillbirth. Proper planning, close observation, and adequately coordinated treatment are necessary to make a successful outcome possible.
Key Takeaway/Note from Icliniq
Pregnancy is more difficult for women who already have renal disease. Proper planning, treatment, and lifestyle changes can all assist in reducing pregnancy risks. iCliniq offers expert consultations for you and your baby. If you have kidney disease and need support during pregnancy, do not wait. Book a consultation at iCliniq.com, and let’s work together to ensure the best possible outcome for you and your baby.
