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, the anxiety of becoming a good parent.

One doesn’t even image any health complications during 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 the normal level near term.
– legs swell, one urinates more frequently.  However,

  • One should not have normal to elevated blood pressure by the time they are in the second or third trimester. Chronic hypertension which is BP >140/90 before 20 weeks of pregnancy usual has normal labs manage successfully with blood pressure medications. Eclampsia >140/90, pre-eclampsia 140-160/90-110. These usually occur in the second trimester require more aggressive control with the early delivery of the baby.
  • One should not have urinary tract infections or pass gravel nor develop kidney stones. These types of infections can sometimes lead to pre-term labor. And the increase in size of the ureters during pregnancy may aid in the stone passing.
  • 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 to have a babyas oppose to pushing for terminating 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.