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Chronic Kidney Disease in Pregnancy

Pregnancy with chronic kidney disease carries substantial risk to the mother and the baby. Incidence of women becoming pregnant while having chronic kidney disease is increasing. The major risk to the mother is development of preeclampsia which may be hard to diagnose in patients with chronic kidney disease. Depending on the kidney function, women may also be at risk of decline in their kidney function. The major risk to baby is prematurity. The renal physiological changes that occur with pregnancy are quite profound and normal values of blood pressure, electrolytes and parameters to monitor kidney function are different then in non-pregnant state. Counselling these women about pregnancy and managing them through pregnancy remains a challenge. This review discusses the physiological changes that occur during pregnancy, risks of pregnancy with CKD and management of CKD during pregnancy.