In the past, if a woman had chronic kidney disease or an autoimmune disorder that affected the kidneys, such as lupus, she was told to avoid pregnancy. But in the last decade, doctors and scientists have worked together and made great progress in supporting women who have kidney disease or an autoimmune disorder and wish to have a baby.
The Ohio State Pregnancy and Kidney Disease Clinic in Columbus opened in 2019. It’s one of a handful of specialized clinics in the nation designed to support women with kidney conditions who are pregnant or wish to become pregnant. We counsel women about the risks of pregnancy, help you in becoming pregnant and provide you with the best care through pregnancy and beyond.
With the right care team, you can know your options, make an informed decision and improve your pregnancy outcomes.
Kidney disease and increased risks in pregnancy
Women who have chronic kidney disease or an autoimmune disorder that affects the kidneys usually have difficulty filtering the blood in their body and eliminating waste. Pregnancy places additional stress on the body and kidneys. If you have a kidney condition, you can be at increased risk of developing the following complications when pregnant:
- High blood pressure
- Pre-term labor
- Relapse of autoimmune disease
- Increased progression of kidney disease
New treatments for kidney disease and autoimmune disorders are making it easier to control your disease and optimize your pregnancy outcomes.
Becoming pregnant with kidney disease
Both the cause of kidney disease and severity of kidney disease influence your chances of becoming pregnant, as well as risks for you and the baby if you become pregnant.
Autoimmune diseases that affect the kidneys can affect the entire body, including fertility. For women with chronic kidney disease, fertility decreases when kidney function decreases. Becoming pregnant may be more difficult.
The team of doctors at Ohio State’s Pregnancy and Kidney Disease Clinic in Columbus, Ohio, have expertise in treating patients with chronic kidney disease and autoimmune diseases who wish to become pregnant. We’ll counsel you about:
- Your fertility
- Ways to become pregnant
- Potential risks to you and baby during and after pregnancy
We’ll recommend the best approach for you based on the cause of your kidney disease and the severity of your disease.
Managing kidney disease while pregnant
When you become pregnant, you’ll be closely monitored in the Pregnancy and Kidney Disease Clinic. We make sure you receive the best care to improve your health and that of your unborn baby.
Typically, a pregnancy is a stress test on the kidneys’ ability to continue to function. Many underlying disorders that cause kidney disease can also cause problems for a developing baby.
If you’re a pregnant woman receiving care at Ohio State’s Pregnancy and Kidney Disease Clinic, you can expect the following support:
- Controlling blood pressure – Patients who have kidney disease are at an increased risk of developing high blood pressure. Blood pressure can be controlled with medication. The team at Ohio State will ensure medication is safe for pregnancy.
- Monitoring progression of kidney disease – Pregnancy increases the pace of kidney disease. Your doctors will monitor the progression of your kidney disease and recommend best treatment practices to slow the rate.
- Monitoring potential relapse of autoimmune disease – Pregnancy increases the chance of an autoimmune disease relapse. Some medications used to treat autoimmune disease are not compatible with pregnancy. Your doctors will recommend medications or treatments that are safe during pregnancy.
- Managing dialysis and other treatments – Patients who are on dialysis before becoming pregnant typically need to triple the amount of time spent on dialysis when they’re pregnant. Your doctors will closely monitor and recommend dialysis and other treatments.
Care by multidisciplinary teams with specialists dedicated to kidney disease and obstetrics can lead to improved outcomes for both mother and baby. We’ll see you at the Pregnancy and Kidney Disease Clinic throughout your entire pregnancy and after delivery.
Kidney disease after pregnancy
We usually see patients at the Pregnancy and Kidney Disease Clinic for a follow-up appointment eight weeks after you have your baby. At eight weeks postpartum, kidney function and hormone levels typically return to pre-pregnancy levels. You’ll have your protein levels checked, and we’ll evaluate the progression of your kidney disease. You’ll then return to your regular autoimmune or kidney disease doctor for continued care.
When to make an appointment with the Pregnancy and Kidney Disease Clinic
You should schedule an appointment with doctors at the Pregnancy and Kidney Disease Clinic prior to becoming pregnant. Doctors will be able to counsel you about becoming pregnant and help you plan for the safest pregnancy and delivery possible while maintaining kidney function.
Ob/Gyns, maternal-fetal medicine physicians and primary care doctors can refer pregnant women who have kidney disease or an autoimmune disorder to the Pregnancy and Kidney Disease Clinic. Sometimes, women don’t discover they have kidney disease or an underlying condition that affects the kidneys until they become pregnant. No matter your stage of pregnancy, the team at Ohio State’s Pregnancy and Kidney Disease Clinic can help provide you with the best treatment options.