Chronic Kidney Disease

Chronic kidney disease is a condition in which the kidneys gradually lose their ability to function. Waste and fluids – which would normally be filtered from the blood by the kidneys and expelled through urine – instead start to build up in the body, causing serious health issues. Untreated, chronic kidney disease can lead to kidney failure, requiring dialysis or a kidney transplant for survival.

Pregnancy is possible for women with chronic kidney disease but it can be challenging, with increased risks to mother and baby. The more advanced the disease, the greater the risk of complications. 

If you have chronic kidney disease and are pregnant or considering pregnancy, you may be referred to a maternal-fetal medicine physician, an OB/GYN who specializes in complex, high-risk pregnancies.

Potential Pregnancy Complications

Women with chronic kidney disease are at increased risk of pregnancy complications that may include:

• High blood pressure or preeclampsia
• Blood clots
• Anemia in the mother
• Low birth weight
• Premature birth
• Need for a cesarean delivery (C-section)

Pregnancy outcomes are determined in large part by a woman’s kidney function at the time of conception and associated medical conditions.

Plan Ahead to Improve Outcomes

Preconception planning can help reduce your risk of complications and improve pregnancy outcomes.

If possible, visit with your health care provider before you become pregnant to:

• Assess your risks and learn how to reduce them
• Review and adjust your medications to avoid adverse
• Begin taking prenatal vitamins, including folic acid to reduce the risk of certain birth defects
• Time your pregnancy when you are at your healthiest, to give your baby the best possible start to life

What to Expect during Pregnancy

Your treatment during pregnancy will depend on the stage of your kidney disease, your overall health, your pregnancy, and the health of your unborn baby.

In general, your prenatal care may include:

• Specialized care from a maternal-fetal medicine physician
• Close monitoring of your blood pressure
• Frequent blood and urine testing to measure kidney function
• Ongoing medication monitoring and adjustments, as needed
• Ultrasounds to monitor fetal growth
• Treatment of anemia, as needed
• Prevention of blood clots, as needed
• Genetic counseling for women with inherited kidney disease
• Delivery at a facility equipped to provide immediate neonatal support for newborns
• A specialized, multidisciplinary health care team including maternal-fetal medicine specialists, nephrologists, mental health support, urologists, fetal medicine specialists, neonatologists and neonatal intensive care unit specialists

The Benefits of Specialized Care

Texas Children’s Pavilion for Women offers specialized care to help women at any stage of chronic kidney disease achieve the safest, healthiest pregnancy possible.

Our maternal-fetal medicine specialists are experienced in the evaluation and management of these complex pregnancies, including those involving kidney transplant and dialysis, carefully assessing and balancing the treatment needs of the mother with the health and safety of her unborn baby.

We offer: 

• Preconception risk assessment and counseling
• Prenatal evaluation and a recommended plan of care tailored to your personal needs and preferences
• Proven experience coordinating the multidisciplinary care required for the best possible outcomes
• State-of-the-art fetal imaging for early detection of fetal growth complications
• Immediate access toTexas Children’s Hospital for babies who need extra care and monitoring, including the level IV neonatal intensive care unit (NICU) at Texas Children’s Newborn Center®, and the Texas Children’s Fetal Center®, a national leader in diagnosing and treating fetal abnormalities
• Access to Texas Children’s Renal Genetics Clinic, as needed
• Emotional support from specialists at The Women’s Place - Center for Reproductive Psychiatry, a unique program dedicated to the care and treatment of women’s reproductive mental health
• Close collaboration with your existing health care providers