Features of Pregnancy Management in Kidney Transplant Recipients.

Abstract

Patients with end-stage renal disease are often infertile or have low pregnancy rates because of hypothalamic dysfunction. These endocrine and menstrual dysfunctions are restored after kidney transplant, which is one of the benefits of kidney transplant for women of childbearing age. Fertility improves rapidly within a few months after kidney transplant, and most women who were previously infertile are then able to conceive. Pregnancy after kidney transplant is challenging because of the risk of adverse complications such as maternal preeclampsia and hypertension, low birth weight, and preterm birth. In addition, there is a risk of side effects from immunosuppressive drugs and a risk of deterioration in graft function. Despite the risk of these complications, clinical analyses of data from our center showed that most pregnancies in kidney transplant recipients were successful and the pregnancy did not significantly affect the function or survival of the graft. Here, we have focused on what we know and what we do not know about "kidney health" and kidney disease in women and what we can and should learn in the future to improve kidney disease outcomes for all people.