How does kidney disease affect someone who is pregnant?

The effect on your pregnancy depends on the severity of the kidney disease you have. Generally, having kidney disease can increase your risk of:

• having a miscarriage
• delivering a baby with low birth weight
• pre-eclampsia
• premature birth
• stillborn child

If you have mild kidney disease, you only have a 20 per cent chance of pre-eclampsia, but if you have severe kidney disease this risk can be up to 60 per cent.

Finally, you’re more likely to need a caesarean if you have kidney disease.

How does being pregnant affect kidney disease?

Pregnancy does not usually have a long-term effect on kidney disease, but your kidney function may be affected while you are pregnant.

If you have severe kidney disease, pregnancy has up to a 50 per cent chance of making it worse.

How is treatment during pregnancy affected by kidney disease?

• If you have kidney disease, your doctor will advise you to take folic acid while you are trying to get pregnant, and then for three months into your pregnancy. This is because your child has an increased chance of developing spina bifida, a serious birth defect, and folic acid can reduce this risk.
• Kidney disease and pregnancy can cause low blood count, so you may be offered iron injections during pregnancy.
• If you have protein in your urine, you have a higher chance of developing blood clots, so you may be offered injections of enoxaparin to reduce this risk.
• You will be offered aspirin throughout the pregnancy to reduce your risk of pre-eclampsia.
• If you take ACE inhibitors for blood pressure you will need to switch to drugs such as Labetalol or Methyl-dopa.

Throughout your pregnancy, you’ll be closely monitored with regular blood and urine testing to keep an eye on the function of your kidneys and check if they are deteriorating, and to spot the warning signs of pre-eclampsia.

Who specialises in treating pregnancy and kidney disease?

There are a number of combined renal/pregnancy clinics around the UK to provide you with specialist advice. The specialist doctor who treats pregnancy and kidney disease is a nephrologist.