Brown M A, Whitworth J A
Department of Renal Medicine, St George Hospital, Kogarah, NSW, Australia.
Am J Kidney Dis. 1992 Nov;20(5):427-42. doi: 10.1016/s0272-6386(12)70255-x.
Many changes in renal function occur in normal pregnancy. Without a proper understanding of these changes, routine clinical investigations may easily be misinterpreted. Women with preeclampsia have further alterations in renal function and, in occasional cases, develop acute renal failure. Understanding of abnormal renal physiology and hormonal changes in these women allows the clinician to interpret biochemical tests appropriately and make proper use of vasodilator therapy with careful attention to volume homeostasis. Women who undertake pregnancy with a primary renal disease, most commonly glomerulonephritis or reflux nephropathy, have a higher risk of adverse fetal and maternal outcomes. Awareness of these risks provides a basis for proper preconceptual counseling, as well as careful monitoring of maternal blood pressure and renal function and fetal growth during such pregnancies. These strategies will optimize the chances of a successful pregnancy outcome for both mother and baby.
正常妊娠时肾功能会发生许多变化。如果对这些变化缺乏正确的认识，常规临床检查结果可能很容易被误解。先兆子痫女性的肾功能会进一步改变，偶尔还会发展为急性肾衰竭。了解这些女性异常的肾脏生理和激素变化，有助于临床医生正确解读生化检查结果，并在密切关注容量平衡的情况下合理使用血管舒张剂治疗。患有原发性肾脏疾病（最常见的是肾小球肾炎或反流性肾病）的女性怀孕时，母婴出现不良结局的风险更高。了解这些风险为孕前进行适当咨询以及在这类妊娠期间仔细监测孕妇血压、肾功能和胎儿生长情况提供了依据。这些策略将优化母婴获得成功妊娠结局的机会。
