Rapper MD

Pregnancy with Kidney Disease

Pregnancy can be an exciting time for a family.

If you know…

A New Life has Arrived.

Creating a new life, the anticipation of how he or she will grow up to be including the anxiety of becoming a good parent.

One doesn’t even imaging any health complications during a pregnancy . Let alone kidney failure.

Normal changes during pregnancy:

– the blood volume increase by 30-50%
– the mother’s blood pressure drops by 10 mmHg especially as she gets to her second trimester.
– moms heart rate increase by 15-20 beats per minute

-blood flow to your kidneys rises 80% above it’s normal baseline

-dilatation of the urinary tract system–i.e. ureters
– on laboratory test your sodium level, calcium level , uric acid level, and creatinine levels all fall about 10% below normal. Then rises back towards pre-pregnant level near term.
– legs swell, one urinates more frequently.  However…

  • One should not have normal to elevated blood pressure by the time they are at second or third trimester.  Chronic hypertension which is BP >140/90 before 20 weeks of pregnancy usual have normal labs manage successfully with blood pressure medications.  Eclampsia >140/90, pre-eclampsia  140-160/90-110.  These usually occur second trimester require more aggressive control with early delivery of the baby.
  • One should not have urinary tract infections or pass gravel develope kidney stones. These type of infections can sometimes lead to pre-term labor. And the increase in size of the ureters during pregnancy may aid in stone passage.
  • One should not go into heart failure.
  • Nor one should not have a large amount of blood nor  protein in their urine.

These conditions signify a newly diagnosed underlying kidney condition OR a current chronic condition going bad.

Either is usually surprising to the family who sees a pregnant mother as being healthy.

Women with chronic kidney disease and/or kidney transplant or on dialysis can indeed have a successful pregnancy . But the outcome is much more favorable when mange together by trained high risk obstetrician and nephrologist whose is passionate and respectful of the mother’s choice win trying to bring forth a child as oppose to pushing termination of her pregnancy.

Call for an appointment or more information at 832-306-3941.

Question: During what month in pregnancy are the kidneys being formed?

Answer : The first trimester. Hence medications like losartan or enalapril are switch to nifedipine or labetalol for blood pressure control.