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Renal Disease in Pregnancy

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Medical Management of the Pregnant Patient

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Abstract

The renal system undergoes significant adaptations in pregnancy to meet the needs of both the pregnant woman and her growing fetus. These changes have important implications in the evaluation and management of gravidas with kidney disorders. Renal disease in pregnancy falls into several categories. It may be chronic and diagnosed prior to pregnancy, chronic but first recognized during pregnancy, or it may present for the first time as an acute disorder in pregnancy. While the majority of women with underlying renal disease in pregnancy will have good pregnancy outcomes, there is an increased risk for adverse maternal and fetal outcomes especially in pregnant women with moderate to severe renal disease. These risks include worsening renal function, increase of baseline proteinuria, worsening hypertension, and the development of superimposed preeclampsia. From the fetal perspective, there is an increased risk of fetal growth restriction, preterm delivery, and the complications of superimposed preeclampsia. Other common disorders during pregnancy include pyelonephritis and renal stones. This chapter will outline renal changes during pregnancy, discuss the impact of pregnancy on renal disease and the impact of renal disease on pregnancy in general, and review several common kidney disorders occurring in pregnancy.

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Author information

Authors and Affiliations

  1. Obstercic Medicine, Women’s Medicine Collaborative, The Miriam Hospital, Providence, RI, 02904, USA

    Lucia Larson M.D.

  2. The Warren Alpert Medical School of Brown University, 146 West River Street, Ste 11C, Providence, RI, 02904, USA

    Lucia Larson M.D.

Authors
  1. Lucia Larson M.D.
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Correspondence to Lucia Larson M.D. .

Editor information

Editors and Affiliations

  1. SVP Women’s Services and Clinical Integration, Lifespan Corporation, Professor and Vice Chair of Medicine Director of Obstetric Medicine, Alpert Medical School at Brown University, Providence, Rhode Island, USA

    Karen Rosene-Montella

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Larson, L. (2015). Renal Disease in Pregnancy. In: Rosene-Montella, K. (eds) Medical Management of the Pregnant Patient. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-1244-1_12

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  • DOI: https://doi.org/10.1007/978-1-4614-1244-1_12

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-1243-4

  • Online ISBN: 978-1-4614-1244-1

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