Kidney disease and hypertension in pregnancy
1. Normal pregnancy is associated with decreased serum creatinine and respiratory alkalosis, causing a decrease in serum bicarbonate.
2. The pathogenesis of preeclampsia is thought to be the consequence of the abnormal development of uterine spiral arteries and placental ischemia leading to increased levels of antiangiogenic factors and low levels of angiogenic growth factors.
3. There is a high rate of fetal loss among pregnant dialysis patients, but this has improved with prolonged dialysis. The outcome of pregnancy in transplant recipients with stable, well-preserved kidney function is good despite immunosuppressive medication.
4. Pregnancy is possible after kidney transplant. A stable immune status and good kidney function is essential. Modification of the immunosuppression will likely be needed.