title: Pregnancy in Chronic Kidney Disease: questions and answers in a changing panorama.
abstract: Chronic kidney disease (CKD) is increasingly encountered in pregnancy because of greater diagnostic awareness, which is a reflection of the newer, broader definitions (i.e., any changes in blood or urine composition or at imaging, or a glomerular filtration rate (GFR) of <60 mL/min lasting at least 3 months) and of increased incidence (higher maternal age and better outcomes of several kidney diseases). CKD is extremely heterogeneous and may be described by the degree of GFR reduction (CKD stages), the presence of proteinuria and hypertension and the type of kidney disease; the risk of adverse pregnancy-related events increases as GFR decreases and it is affected by proteinuria and hypertension. Specific risks are reported in various diseases such as lupus nephropathy or diabetic nephropathy. While transplantation at least partially restores fertility in end-stage kidney disease, pregnancy on dialysis is increasingly reported. This chapter deals with the available evidence on the management of CKD patients in pregnancy.
authors.affiliation: SS Nefrologia, Department of Clinical and Biological Sciences, ASOU San Luigi Gonzaga, University of Torino, Turin, Italy. Electronic address: gbpiccoli@yahoo.it.
authors.forename: Giorgina Barbara
authors.initials: GB
authors.lastname: Piccoli
authors.affiliation: SCDU Nephrology, Brotzu Hospital, Cagliari, Italy.
authors.forename: Gianfranca
authors.initials: G
authors.lastname: Cabiddu
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Rossella
authors.initials: R
authors.lastname: Attini
authors.affiliation: SS Nefrologia, Department of Clinical and Biological Sciences, ASOU San Luigi Gonzaga, University of Torino, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Vigotti
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Fassio
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rolfo
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Domenica
authors.initials: D
authors.lastname: Giuffrida
authors.affiliation: SCDU Nephrology, Brotzu Hospital, Cagliari, Italy.
authors.forename: Antonello
authors.initials: A
authors.lastname: Pani
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Piero
authors.initials: P
authors.lastname: Gaglioti
authors.affiliation: Materno-Foetal Unit, Department of Obstetrics, ASOU OIRM S Anna, University of Torino, Turin, Italy.
authors.forename: Tullia
authors.initials: T
authors.lastname: Todros
mesh_terms: D037001:Directive Counseling; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D007676:Kidney Failure, Chronic / Q000503:physiopathology / Q000628:therapy; D016030:Kidney Transplantation; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*
keywords: chronic kidney disease (CKD); dialysis and transplantation; glomerulonephritis and interstitial nephropathies; hypertension; pregnancy; proteinuria