Kidney Week

Abstract: FR-PO0984

Successful Pregnancy in a Patient with Advanced CKD

Session Information

• Women's Health and Kidney Diseases
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Hu, Rongrong, Peking Union Medical College Hospital, Beijing, China

Rongrong Hu, MS

• Zheng, Ke, Peking Union Medical College Hospital, Beijing, China

Ke Zheng, MD

• Xia, Peng, Peking Union Medical College Hospital, Beijing, China

Peng Xia, DrMed

• Li, Shu, Peking Union Medical College Hospital, Beijing, China

Shu Li, MD

• Ma, Liangkun, Peking Union Medical College Hospital, Beijing, China

Liangkun Ma, MD

Introduction

We reported an advanced chronic kidney disease(ACKD) women who successfully achieved full-term pregnancy by multidisciplinary management, and summarized the experience.

Case Description

A 33 year-old pregnant woman visited our clinical. She was diagnosed glomerulonephritis at 15 and developed hypertension at 25. On intermittent laboratory follow-up, mild proteinuria, intermittent hematuria and gradually increased serum creatinine(sCr) was identified. Evaluation at 8⁺¹ weeks pregnancy found her 24hUp 0.59g, sCr 401μmol/L(eGFR 12.4ml/min/1.73m²), urea 10.78mmol/L, normal electrolytes. Although medications she took were potentially teratogenic and pregnancy was associated with high maternal and fetal risks, she insisted on pregnancy. Subsequently, she got multidisciplinary follow-up. The obstetrician instructed her to practice Tai Chi and prescribed aspirin in the second trimester. The nutritionist provided dietary guidance, keeping her protein intake 0.8g/kg/d. We adjusted her antihypertensive therapy to maintain blood pressure(Bp) ≤140/90 mmHg, instructed low-potassium(K) dietary and monitored dialysis indications. Her serum albumin and renal function (Figure 1), serum K were stable without edma, dialysis was suspended. On 37⁺¹ weeks of pregnancy, she gave birth to a boy weighing 2400g (5^th-10^th centile). He got Apgar score 10. One year after delivery, her renal function was stable and dialysis wasn't required. Her baby grows well as the same age group.

Discussion

Multidisciplinary team to conduct meticulous management of ACKD women is extremely important. As nephrologist, the following issues should be addressed: maintaining Bp ≤140/90 mmHg whether by exercise or medication. Moderate dietary protein restriction is a feasible strategy such patients. Initiating dialysis merely based on urea level requires more cautious assessment. Well-controlled blood pressure and preserved residual urine volume may be protective against dialysis.
The present case refined multidisciplinary management is of great necessity for pregnant ACKD women and may attenuate the effect of pregnancy on renal function deterioration.

Acknowledgment

The authors are grateful to Fund of Chinese Medical Board and Undergraduate Education Reform Project PUMC for supporting.