Q J Med 1999; 92: 631-635
© 1999 Association of Physicians
Pregnancy does not adversely affect renal transplant function
From the Renal Unit and Renal Transplant Unit, Royal Liverpool University Hospital and The Liverpool Womens' Hospital, Liverpool, UK
Received 19 March 1999 and in revised form 24 August 1999
Dr A.V. Crowe, 6C Link, Royal Liverpool University Hospital, Prescot Street, Liverpool L7 8XP. e-mail: avcrowe{at}aol.com.uk
Women with functioning transplanted kidneys often become fertile again. Indeed, renal function, endocrine status and libido rapidly improve after renal transplantation, and 1:50 women of childbearing age become pregnant. However, there is concern regarding the haemodynamic changes of pregnancy, which could lead to a decline in graft function (temporary or permanent). We examined obstetric data and renal parameters in 29 patients and 33 pregnancies. Mean serum creatinine and creatinine clearance remained stable throughout pregnancy and 1 year postpartum. However, there was a significant increase in proteinuria from a mean of 0.45 g/24 h around the time of conception to 1.11 g/24 h at delivery (p<0.05). The proteinuria resolved to baseline levels at 3 months postpartum. We highlight certain parameters to be considered before conception to allow a good obstetric outcome and prolong stable renal function: serum creatinine <150 µmol/l, proteinuria <1 g/day, absence of histological evidence of chronic allograft rejection, controlled blood pressure (140/90) and stability of maintenance immunosuppression.