title: Chronic kidney disease in pregnancy.
abstract: Parturients with renal insufficiency or failure present a significant challenge for the anesthesiologist. Impaired renal function compromises fertility and increases both maternal and fetal morbidity and mortality. Close communication amongst medical specialists, including nephrologists, obstetricians, neonatologists and anesthesiologists is required to ensure the safety of mother and child. Pre-existing diseases should be optimized and close surveillance of maternal and fetal condition is required. Kidney function may deteriorate during pregnancy, necessitating early intervention. The goal is to maintain hemodynamic and physiologic stability while the demands of the pregnancy change. Drugs that may adversely affect the fetus, are nephrotoxic or are dependent on renal elimination should be avoided.
authors.affiliation: Division of Obstetrical Anesthesia, Sunnybrook Health Sciences Centre, Toronto, Canada.
authors.forename: V
authors.initials: V
authors.lastname: Chinnappa
authors.forename: S
authors.initials: S
authors.lastname: Ankichetty
authors.forename: P
authors.initials: P
authors.lastname: Angle
authors.forename: S H
authors.initials: SH
authors.lastname: Halpern
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical / Q000379:methods; D004573:Electrolytes / Q000378:metabolism; D005260:Female; D006801:Humans; D007668:Kidney / Q000473:pathology / Q000503:physiopathology; D016030:Kidney Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy*; D015656:Respiratory Mechanics / Q000502:physiology
chemical_list: D004573:Electrolytes