Traditionally, pregnancy is considered to be a risk factor for accelerating the decline of renal function, increasing proteinuria and hypertension; late renal insufficiency, proteinuria, hypertension and poor control of basic primary kidney disease are significant risk factors for adverse pregnancy outcomes and kidney outcomes. However, the clinical basis of this view is not yet sufficient.
Current studies have shown that most women with mild/moderate renal insufficiency with normal blood pressure can succeed in pregnancy, but they are more prone to complications than pregnant women with normal renal function. In the late stage of renal insufficiency, pregnancy is more dangerous. In women with advanced CKD, decreased renal function leads to hormone changes, decreased fertility and lower chance of pregnancy. Even if pregnancy is successful, late CKD patients are more likely to develop intrauterine growth retardation and premature delivery.
Late CKD women should be informed that their fertility decline can be caused by a variety of reasons.
But fertility can be restored after kidney transplantation. Because pregnancy outcomes deteriorate with the progress of CKD, kidney transplantation is often recommended for young women planning to become pregnant. If kidney transplantation is not possible, nighttime hemodialysis can be used to restore menstruation and improve the chances of pregnancy. But it is dangerous for patients to live longer and better.
Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be discontinued before pregnancy or as early as possible after pregnancy is detected. In China, most of patients take Micro-Chinese Medicine Osmotherapy to repair damaged kidney, which has good effects on improving kidney functions to increase the successful rate of pregnancy.
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