ABSTRACT

The ‘physiological hydronephrosis’ of pregnancy can be dismissed as normal up to a pelvicaliceal diameter of about 2 cm. Although urinary tract infection is a common and important problem in pregnancy, it should never be assumed to be the cause of abdominal pain and/or proteinuria before further investigation to confirm or refute the diagnosis is undertaken. Increased proteinuria is a physiological response to pregnancy and may not necessarily indicate superimposed pre-eclampsia or deteriorating renal disease. It also results from withdrawal of angiotensin-converting enzyme inhibitors/angiotensin receptor blockers before or in early pregnancy. In general, women without hypertension or renal impairment prior to conception have successful pregnancies and pregnancy does not adversely influence the progression of the kidney disease. Women receiving renal transplants should be counselled that as renal function returns to normal (usually rapidly after successful transplantation), ovulation, menstruation and fertility also resume.