# Kidney and Pregnancy: A Comprehensive Review

## TL;DR

This review explores how kidney health is affected during pregnancy and highlights conditions that can impact both the mother and baby.

## Contribution

The paper provides a comprehensive overview of nephrological conditions during pregnancy, including their management and consequences.

## Key findings

- Preeclampsia and HELLP syndrome are severe pregnancy-related conditions requiring urgent care.
- Chronic kidney disease increases risks of preterm birth and fetal growth restriction.
- Acute renal failure during pregnancy can result from various serious conditions like thrombotic microangiopathy.

## Abstract

During pregnancy, a series of physiological changes occur in women, particularly affecting the cardiovascular system with significant hemodynamic alterations. Subsequently, this leads to renal adaptations manifesting through variations in glomerular filtration rate. This close interconnection between the heart and kidneys implies that issues arising in one organ will disrupt this fundamental balance, inevitably involving all associated organs. The purpose of this review is to gather all possible nephrological conditions that may arise during pregnancy, as well as pre-existing conditions that may become apparent or worsen during this period. This review describes the natural history, treatment, and impact of these conditions on pregnancy itself. Among the most common conditions are preeclampsia and HELLP syndrome, severe complications characterized by hypertension, proteinuria, and multiorgan damage that require immediate clinical attention. Additionally, women with chronic kidney disease are at higher risk of developing maternal–fetal complications, such as preterm birth and intrauterine growth restriction. Common causes of acute renal failure are also analyzed, including thrombotic microangiopathy, acute fatty liver of pregnancy, acute onset or flare of systemic lupus erythematosus, and catastrophic antiphospholipid antibody syndrome. Given the importance of proper renal function during pregnancy, it is essential to have a thorough understanding of nephrological diseases that may affect this phase of women’s lives. This knowledge is crucial for managing these conditions effectively to avoid risks to the survival of both the mother and the newborn.