ABSTRACT
Renal disease is an important predisposing factor for preeclampsia and fetal growth restriction (FGR). There is dilatation of the ureters and renal calyces in pregnancy. Urinary tract infection is more common in pregnancy because of the physiological dilatation of the upper renal tract. If renal disease is not diagnosed pre-pregnancy, it is usually first recognised because of hypertension and proteinuria and/or haematuria in early pregnancy, prompting blood tests for urea and creatinine. All women with renal impairment are at increased risk of preeclampsia, FGR, and spontaneous and iatrogenic preterm delivery. Many renal patients, especially those with significant proteinuria, are treated with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin receptor blockers (ARBs). Because women with end-stage renal failure have markedly reduced fertility, pregnancy on dialysis is unusual. Dialysis may rarely become necessary, but a need for long-term renal replacement therapy is extremely unusual.
