Can I get pregnant if I have CKD?
You can get pregnant if you have chronic kidney disease (CKD). Your stage of CKD will affect your ability to get pregnant and your risk of certain complications during pregnancy.
When considering pregnancy, the most important factor is timing. You should tell your nephrologist (kidney doctor) early about your family planning goals and discuss your options. Planning in advance can help ensure a safe pregnancy for both you and your baby. Even if you don’t want to have children soon, let your nephrologist know if you want to in the future. This will help them understand your goals and values when deciding the best way to treat your kidney disease.
Pregnancy in stages 1 and 2
If you are in the early stages of CKD and you have normal blood pressure and low levels of protein in your urine, you will likely experience a healthy, normal pregnancy.
Having high blood pressure is one of the strongest predictors of preterm birth (before 34 weeks). High blood pressure is also a risk factor for preeclampsia, a condition that occurs when blood flow to the placenta is disrupted and the placenta does not develop properly. Preeclampsia is a common complication for patients with CKD who are pregnant.
For patients with CKD who are in the early stages of pregnancy, it is recommended to monitor your blood pressure throughout the pregnancy. You can do this with a home blood pressure cuff and write down each reading. Your doctor will monitor your blood pressure, test your urine for protein, and monitor your BUN and creatine levels throughout pregnancy to assess how well your kidneys are working.
Pregnancy in stages 3 and 4
Like yours glomerular filtration rate (GFR) declines, as does fertility. If you are in the later stages of CKD, you are more likely to experience problems conceiving and carrying your pregnancy for the full nine months, which is sometimes called carrying to term.
Pregnancy in the later stages of CKD comes with an increased risk of preeclampsia, especially if you have high blood pressure and high levels of protein in your urine.
There is also a higher risk of reduced kidney function during pregnancy. Pregnancy can strain the kidneys. For those with kidney disease, this can cause you to lose kidney function. Some women with advanced kidney disease may need to start dialysis as a result of pregnancy.
Pregnancy in end-stage renal disease (ESRD)
Improvements in dialysis delivery have improved pregnancy outcomes with ESRD on dialysis. However, pregnant dialysis patients still face many risks and complications.
Patients on hemodialysis have fewer complications in becoming pregnant and becoming pregnant than patients peritoneal dialysis. Talk to your doctor about the best dialysis option for you.
If you are on hemodialysis, you can expect changes to your dialysis regimen. This will include an increase in the time spent on dialysis, which can be achieved by performing hemodialysis at home or overnight. Many pregnant dialysis patients need 24-36 hours of dialysis per week. Changes to your nutrition plan can be made to increase the amount of vitamins and minerals you consume, which are essential for the growth of a healthy baby. You also need to make sure you get enough protein.
As your pregnancy progresses, you will have increased monitoring and surveillance, including assessment of the baby’s growth and the amount of fluid (called amniotic fluid) around the baby. Blood pressure will also be monitored to watch for preeclampsia.
When it is time to deliver the baby, it is recommended to deliver in a hospital with access to a neonatal intensive care unit (NICU), as the frequency of early birth is common. This is a part of the hospital that has special equipment, doctors and nurses who take care of newborn babies who need extra monitoring.
Pregnant dialysis patients can give birth either vaginally or via caesarean section.
Pregnancy by transplantation
Post-transplant pregnancies have high live birth rates, as do pregnancies in people without CKD.
The most important consideration for kidney transplant recipients is to wait 1 to 2 years before becoming pregnant. Some medicines given after transplantation to prevent rejection (immunosuppressants) can be harmful to babies (teratogens). It is important to talk to your doctor about these medicines and make any necessary changes before you become pregnant.
