When Do CKD Patients Get Pregnant
Which patients are not suitable for pregnancy?
Patients with stage 3-5 kidney disease, uncontrollable high blood pressure and proteinuria are not suggested to get pregnant. Diabetic Nephropathy patients with mild and severe kidney function damage are not suggested to get pregnant when they have irreversible kidney function after getting pregnant. Pregnancy should not occur within 2 years of onset of lupus nephritis.
In view of the decreased fertility of dialysis patients, dialysis time needs to be increased to over 36h to improve the live birth rate of fetus. Even if dialysis is enhanced, it is still dangerous for patients to get pregnant. After the occurrence of pathological pregnancy, patients still have higher risk of bleeding when medicines or surgery terminates the pregnancy. At the same time, due to the limitation of dialysis condition, pregnant women are not recommended to take hemodialysis and peritoneal dialysis.
What to notice when using medicines before pregnant?
Control high blood pressure
It is important to control blood pressure before pregnancy and during pregnancy. Blood pressure should be lower than 140/90mmHg before pregnancy. Antihypertensive drugs include methyldopa and labetalol. Calcium channel antagonists are also effective for high blood pressure like nifedipine GITS and nimodipine. Angiotensin converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) may cause fetal growth restriction, renal dysplasia, and oligohydramnios, which should be banned during pregnancy. However, because ACEI can effectively improve proteinuria, it can be used in patients with poor proteinuria control, improve and stabilize the drug withdrawal before pregnancy. Diuretics can lead to blood concentration, hypercoagulability, and are used only in cases of systemic edema and acute cardiac and renal failure.
Treatment for proteinuria
Poor control of urinary protein has adverse effects on pregnancy outcome, and urinary protein > 1g/24h is not suitable for pregnancy. Hormones, immunosuppressants, ACEI/ARB and other drugs should be reasonably used to control proteinuria. ACEI can effectively help refractory proteinuria.
Aspirin (75mg/d) reduces the incidence of preeclampsia and improves pregnancy outcomes in patients with lupus nephritis. Therefore, all patients with CKD with no contraindications, may consider starting the drug before pregnancy or as early as possible during pregnancy. The risk of venous thrombosis is increased in patients with nephrotic syndrome hypoproteinemia (albumin < 25g/L), which can be treated by low-molecular-weight heparin (LMWH).
There is a relative lack of EPO during pregnancy, and the existence of pregnancy-related inflammatory factors leads to EPO resistance. Severe anemia can occur in pregnant women with CKD and affect fetal growth.
It is possible for CKD patients to get pregnant if you control your condition well. About more information, welcome to leave a message below or consult online doctor directly.
***Please seek professional medical advise for the diagnosis or treatment of any ailment, disease or medical condition. This article is not intended to be a substitute for the advice of a licensed medical professional.***