During a normal pregnancy, the urinary system undergoes significant but predictable physiologic and anatomic changes. Pregnancy-specific kidney disorders can be divided into two categories: those that occur early in pregnancy and those that occur later in pregnancy:
Early pregnancy disorders include prerenal azotemia, acute tubular necrosis, renal cortical necrosis, pyelonephritis, and thrombotic thrombocytopenic purpura.
Late pregnancy disorders include pre-eclampsia, acute fatty liver of pregnancy, and hemolytic-uremic syndrome.
Kidney injury in early pregnancy: symptoms of renal cortical necrosis (RCN) include severe oliguria and anuria, flank discomfort, and extensive hematuria if caused by renal cortical necrosis.
Kidney injury in late pregnancy: Abdominal discomfort and jaundice in case of liver gets affected.
Book an appointment with your gynaecologist right away if you experience any of these symptoms.
During a typical pregnancy, the physiology and anatomy of the urinary system change significantly but predictably. The two categories of kidney problems specific to pregnancy are those that develop in the early and late stages of the pregnancy:
Kidney injury in early pregnancy: Any cause resulting in volume depletion during pregnancy like hyperemesis gravidarum, hemorrhage from spontaneous abortion, and Renal cortical necrosis (RCN)
Kidney injury in late pregnancy: preeclampsia, but it can also be caused by HELLP syndrome or by uterine hemorrhage with abruptio placentae or micro vesicular fatty infiltration of hepatocytes in case of acute fatty liver.
Kidney injury in early pregnancy: Radiolucent rim in the brain on computed tomography (CT) scans, urine indices with an enhanced fractional excretion of sodium.
Kidney injury in late pregnancy: Laboratory investigations assessing levels of bilirubin, aspartate aminotransferase (AST), and alanine aminotransferase (ALT). CT and ultrasound imaging are additional useful diagnostic techniques.
Patients with chronic kidney disease (CKD) are managed with 24-hour urine protein collections, renal function testing, and blood pressure monitoring
Kidney injury in early pregnancy: Hospitalization and the administration of intravenous fluid and intravenous antibiotics such as Ceftriaxone; Plasma exchange or plasmapheresis along with the use of high-dose corticosteroids; temporary dialysis until renal function recovers; volume replacement or fluid resuscitation with intravenous normal saline and frequently potassium and pressors for hypotension; and, if necessary, patients may need dialysis.
Kidney injury in late pregnancy: Immediate delivery, supportive care, and liver transplantation may be necessary if the liver is harmed. Eculizumab is utilized as the preferred medicine for a few disorders.
Patients with more severe illness and those who have progressive renal failure must see a nephrologist for advice.
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