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Renal disease in pregnancy 

Renal disease in pregnancy
Chapter:
Renal disease in pregnancy
Author(s):

Kate Wiles

DOI:
10.1093/med/9780198746690.003.0267
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date: 27 February 2021

Pregnancy leads to extensive and complex physiological changes in the kidney and renal system. This chapter explores the various complications that can occur in the renal system of the pregnant woman, including acute kidney injury, chronic kidney disease, and urinary tract infection. The causes of acute kidney injury in pregnancy are as those in the non-pregnant patient, but additional pregnancy-related pathologies must be considered, including pre-eclampsia and HELLP syndrome. Microangiopathic haemolytic anaemias (haemolytic uraemic syndrome and thombotic thrombocytopenic purpura) are rare but can be triggered by pregnancy or the post-partum state. Failure of the renal system to adapt to pregnancy is hypothesized to lead to the increase in adverse maternal and fetal outcomes seen in women with chronic kidney disease. Asymptomatic bacteriuria affects 2–10% of pregnant women and is associated with increased risks of symptomatic infection, preterm birth, low birth weight, and perinatal mortality. Antibiotic treatment mitigates these risks.

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