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Kidney Disease and Pregnancy
How to protect you and your baby
Kidney disease during pregnancy is an increasingly common condition amongst U.S. mothers. Around 1 in 3 adults is at risk for kidney disease, and the condition is more common in women than in men. In fact, approximately 14.3 percent of women age 18 and older have a chronic kidney disease diagnosis.
Women with chronic kidney disease during pregnancy often adapt poorly to the gestational increase in renal blood flow. In other words, pregnancy can expedite renal failure in the mother and cause poor health outcomes for her baby. If you have chronic kidney disease and are pregnant, or if you are experiencing kidney problems during pregnancy, here’s what you need to know.
Stages of kidney disease during pregnancy
Specific concerns exist for pregnant mothers experiencing different stages of kidney disease. There are 5 stages of kidney disease.
- Stage 1: Mild kidney damage. The kidneys are healthy and working well, but there are some signs of kidney damage. At this stage, doctors often recommend that you control your blood pressure, eat a healthy diet high in omega-3 fats, avoid tobacco and exercise.
- Stage 2: Mild but exacerbated kidney damage. Signs of this stage of kidney damage include protein in the urine and physical damage to the kidneys. Doctors often recommend lifestyle changes and medications.
- Stage 3: Moderate kidney damage. At this stage, the kidneys are damaged and not working as well as they should. Symptoms can include swelling in the hands and feet, infrequent or too-frequent urination, chronic back pain, anemia, bone disease and high blood pressure. Doctors often recommend lifestyle changes, frequent nephrology visits and medications, including blood pressure medicine.
- Stage 4: Moderate-to-severe kidney damage. At this point, the kidneys are not working as they should. You can expect worsening of previous symptoms, including anemia, high blood pressure, bone disease, swelling and back pain. Patients with stage 4 kidney disease need regular appointments with their nephrologist and a personalized treatment plan. This is the last stage before kidney failure, and it should be taken seriously by both the patient and the clinician.
- Stage 5: Kidney failure. The last stage of kidney disease is where the kidneys are either close to shutting down or have stopped working altogether. Symptoms include muscle cramps, nausea, lack of appetite, itching, back pain, swelling, trouble breathing and infrequent urination. Treatment options include dialysis and transplant. Untreated stage 5 kidney disease is fatal.
Kidney disease symptoms can be tricky to identify without the help of a clinician because pregnant women commonly experience changes in their bladder habits during pregnancy anyway. If you think you may have kidney disease, or if you are at risk for developing kidney disease, be sure to talk with your doctor.
How does kidney disease affect pregnancy?
In general, women with mild kidney disease (stages 1 and 2) who have normal blood pressure and little-to-no proteinuria (protein in the urine) can experience a healthy pregnancy. However, women with moderate-to-severe kidney disease (stages 3, 4 and 5) are at high risk for complications.
In mild cases of chronic kidney disease, pregnancy does not necessarily cause the condition to worsen. Chronic kidney disorders are exacerbated when a pregnant woman also has high blood pressure.
However, if a pregnant woman has a kidney disorder, they are more likely to develop high blood pressure. This is known as preeclampsia, and it can lead to seizures, health risks for the baby and sometimes death. If you have a chronic kidney condition and are pregnant, it’s essential to monitor your blood pressure throughout your pregnancy, especially during the 3rd trimester.
Women with chronic kidney disorders are at a higher risk for having babies that are small for their gestational age. Severe kidney disorders can make it more difficult for a woman to carry her baby to term and can result in a stillbirth.
Common conditions that arise from chronic kidney disease during pregnancy
There are several conditions known to arise from kidney disease during pregnancy that can affect both the mother and her baby. For example, chronic kidney disease can lead to premature labor or early delivery. Pregnant mothers with kidney disease may experience severe hypertension and anemia, which affect blood flow to the fetus. This can harm both the mother and her baby.
Additionally, infants born from mothers with chronic kidney conditions are at an increased risk of metabolic bone diseases and gestational diabetes.
Find a compassionate care team
If you have kidney disease and are pregnant or thinking about becoming pregnant, it’s important to make an appointment with a qualified OB-GYN as soon as possible.