Can kidney disease health online | Can kidney disease get pregnant?

Children are the most precious wealth of parents, and pregnancy is an indispensable topic of family. While the birth of new life brings happiness to the family, it may also bring some concerns.

The majority of patients with kidney disease often face three kinds of confusion: Can I get pregnant? When should I get pregnant? What should I pay attention to after pregnancy? Let's take a closer look today.

1. Can you get pregnant?

If you want to have a baby, you must pay attention to your own creatinine, blood pressure, and proteinuria before pregnancy. If the above three aspects are well controlled, most kidney friends can prepare for pregnancy. If the above situation is not good, there may be risks in pregnancy. It will accelerate the deterioration of chronic kidney disease.

01 Pay attention to your creatinine at all times, and it is best to prepare for pregnancy.

Patients with good renal function (creatinine <123.7 μmol/L) and normal blood pressure, pregnancy success rates are> 95%.

Pregnancy is used at moderate damage to the kidney function (creatinine 133-264 μmol/L). Although the fetal activity rate can reach 90 %, there is serious risk of maternal fetus, such as premature birth, low weight, maternal kidney function, kidney injury, and difficult to be in the late pregnancy period. Controlled hypertension, etc., it is recommended to avoid pregnancy.

02 Regularly review proteinuria to avoid bad pregnancy endings.

Patients with urine protein <1g/24h can try to get pregnant. Excessive proteinuria levels will have a adverse effect on the ending of the pregnancy. For patients with chronic kidney disease, they should be performed every 4-6 weekly hospitals during pregnancy. Protein monitoring.

03 Actively control blood pressure and protect the fetus.

Chronic kidney disease Mothers have high blood pressure may increase the risk of fetal development or premature birth. Even when blood pressure> 140/90mmHg can directly affect the fetal survival rate. As a pregnant mother, the blood pressure should be controlled at 130-140/80-90mmHg. If there is an abnormal blood pressure, you should go to the hospital for treatment in time.

Answer for three women with different kidney diseases with different kidney disease

01 Xiao Zhang, female, 35 years old, had chronic nephritis, proteinuria, hematuria, and creatinine were relatively stable. In the past two years, creatinine is at 80-90 μmol/L. Currently taking drug treatment.

Q1: Doctor, I have been chronic kidney disease for 3 years. I want to prepare for pregnancy recently. Can you see my disease?

A1: Patients with chronic kidney disease may be lower than normal people. At the same time, it is more likely to have complications during pregnancy, such as hypertension during pregnancy, eclampsia, and the risk of mothers and fetuses during pregnancy, which may cause further deterioration of renal function. According to your current situation, comprehensive evaluation can be prepared for pregnancy, and some preparations need to be prepared to reduce the risk of pregnancy as much as possible.

Q2: If you can have a baby, how do I need to prepare for it? Do you need to pay attention?

A2: First of all, it is necessary to evaluate whether the blood pressure of the past three months is controlled at the normal level, whether the renal function is stable, and whether the proteinuria is stable than 1g/24h. Unless other factors to accelerate the deterioration of the renal function, the pregnancy should be discontinued in the medication. There are taboos, such as cyclopensicide, for at least 3-6 months such as phenolic phenols, Salin, and Puli. According to these five aspects of the evaluation results, if you are in good condition, you can get pregnant. For patients with other circumstances, if there is a strong pregnancy needs, the doctor of kidney disease and a high -risk pregnancy -induced medical physician should be evaluated and followed closely.

02 Xiao Li, 20 years old, has a systemic lupus erythematosus for 2 years. It is currently in a state of disease relief. Proteinuria, creatinine, and blood pressure are normal.

Q1: Do you, will the systemic lupus erythematosus affect my future fertility?

A1: Lupus does not affect your fertility, but it will increase the risk of your mother and fetus during pregnancy.

Q2: Do you, when is my disease most suitable for pregnancy?

A2: The timing of pregnancy needs to be judged from your condition, laboratory examination, and medication.

In terms of illness, there should be no lupus activity in the first half of pregnancy or even a year of pregnancy;

In terms of inspection, it should be ensured that your renal function stabilizes (creatinine ≤140 μmol/L) If there is a positive anti -phospholipid antibody, you should wait for the anti -phospholipid antibody to the yin for more than 3 months before considering the pregnancy;

In terms of medication, pre -pregnancy daily daily should be less than 10 mg per day, and cytotoxic drugs (cycosamide, methotrexate, thunderobacide, etc.) should be used for at least half a year.

Q3: Doctors, how can I avoid these smooth pregnancy?

A3: The risk of pregnancy must exist, but this risk can be reduced through a detailed pregnancy plan. First of all, the activity of systemic lupus erythematosus should be monitored at all times, and a specialist should be evaluated regularly. Secondly, we should continue to use drugs suitable for pregnancy and continuous medication during pregnancy, and cannot stop taking drugs that control the activity of the disease. Finally, it should be regularly visited by specialist trainers, maternal tire monitoring, immunology and chemical examinations.

03 Little King, female, 35 years old, chronic kidney disease 5 stage, blood creatinine 650 μmol/L or more, protein urine 2+, blood pressure control is unstable, and is currently in the dialysis stage.

Q1: Doctor, my kidney disease has reached the stage of dialysis, can I still have birth?

A1: Patients with dialysis are not recommended for pregnancy.

Q2: Why don't you recommend pregnancy?

A2: The fertility ability of patients with dialysis must be reduced, and the dialysis needs to be strengthened (the periad dialysis time is increased to> 36h) to increase the survival rate of the fetus. Even so, the pregnancy will face high risk. High risk and dialysis conditions are not recommended for patients with dialysis. Common nephropathy pregnancy taboos

01. Pregnancy contraindications use immunosuppressive drugs

Circinamide, is the phenolin (teratogen), lymite, methotrexate (teratogenic).

02. Anti -suppressive drugs for pregnancy avoid

Antolol, Promol, screw, Salin, Prilum, sodium nitrate.

Note: If there are other medications during pregnancy, it is recommended to consult a specialist or an obstetrician and gynecologist for evaluation, and adjust it if necessary.

03. Drugs that can be taken safely in pregnancy

Panson pine tablets can be treated in small doses such as 10mg/day, and mothers and fetuses must be tightly monitored during the medication.

Circus A, Hekmomis, and Lipidifact are considered relatively safe. If you still cannot be discontinued during pregnancy, you need to monitor the concentration of blood medicine.

Hydroxyl chloride can be taken.

Some antihypertensive drugs can be taken: such as methylba, Labelol, and nifedenine (but nitopenpine horizontal controlplates are prohibited for pregnant women within 20 weeks of pregnancy).

The pregnancy of patients with kidney disease is like a twisted and difficult path. It needs to pass the layer of kidney examination before preparing for pregnancy. Those with thorough follow -up and review arrangements need to be formulated.

The pregnancy of patients with kidney disease should be forced to do with force, and timely do a good job of pre -pregnancy consultation, pregnancy plan, and supervision and management during pregnancy. These are important measures to avoid the risk of pregnancy.

I wish you all the "pregnancy"!

Expert

Hou Haijing

The Department of Nephrology of Dade Road General Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine, deputy chief physician, doctor of medicine, and master's tutor.

Good at: Traditional Chinese medicine or traditional Chinese and Western medicine treats chronic nephritis, nephropathy syndrome, acute and chronic renal failure, lupus nephritis, vasculitis damage, and other primary and secondary kidney diseases. Skilled surgery and operations such as peritoneal dialysis, hemodialysis, and renal biopsy. Mainly attack chronic kidney disease in Chinese medicine.

Supply: Duan Ruoran Jiecina, Duan Ruoran, Da De Road General Hospital of Guangdong Province

Executive editor: Wu Yuan Tuan

Audit school pair: Zhuang Yingge

Editor in charge: Song Liping

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