Pregnancy and Ckd: Always a Challenge!

Abstract

Pregnancy associated with chronic kidney disease (CKD) have a significant fetal and maternal risk, including developing preeclampsia, prematurity and progress of renal function. Is CKD a barrier in conception? The aim of the study was to monitor the maternal and fetal evolution and complications occurring during pregnant patients with different degrees of CKD. Our study used a descriptive and prospective plan for analyzing pregnancies of women with CKD and the fetal and maternal impact of it. A total of 23 patients were included in the study and were followed for three years. Results: Of total number of 104 patients with renal pathology included in studied group, 23 had chronic kidney disease (22%) and the rest of it had acute renal insufficiency or infectious renal pathology. Depending on the evolution of CKD there were 8 cases with acute deterioration of renal function and 15 cases in which the renal function remained stationary. The underlying renal disease was represented by autosomal dominant polycystic kidney disease, diabetic nephropathy, chronic pyelonephritis, glomerular nephropathies, and women who have already been on hemodialysis therapy. Urinary tract infections, nephrotic syndrome and preeclampsia were the main causes of acute on CKD. Complications were represented by spontaneous abortions, prematurity, septic shock and, in some cases, followed by progression of CKD stage. Conclusions: Pregnancy associated with CKD represents a challenge for physicians, even in early stages, and it is necessary to be monitored in a multidisciplinary team, for reducing fetal and maternal risks.