Deodhare Kirti Girish, Pathak Nabadwip
Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bathinda 151001, Punjab, India.
Department of Nephrology, All India Institute of Medical Sciences, Bathinda 151001, Punjab, India.
World J Nephrol. 2024 Dec 25;13(4):100680. doi: 10.5527/wjn.v13.i4.100680.
The growing incidence of obesity and the rising trend of increased age during pregnancy have led to a high number of pregnant women with chronic kidney disease (CKD). Chronic hypertension is commonly associated with CKD and is not only the result of renal damage but is also the cause of declining renal function. Pregnancy and its unique physiological adaptations are affected by a decrease in the filtration capacity of the kidneys. Preeclampsia is a disorder of the vascular endothelium and is exacerbated by endothelial dysfunction resulting from CKD. Blood pressure targets must be strictly maintained owing to overlapping disease pathogenesis and to minimize cardiovascular damage. Moreover, preexisting renal dysfunction poses a challenge in identifying superimposed preeclampsia, which alters the management strategies in pregnancy. Fetal outcomes in patients with CKD are considerably affected by the presence of hypertension. This review is expected to aid in developing a focused and individualized treatment plan for hypertension in pregnant women with CKD to improve pregnancy outcomes and preserve postpartum renal function.
肥胖发生率的不断上升以及孕期年龄增加的趋势，导致大量患有慢性肾脏病（CKD）的孕妇。慢性高血压通常与CKD相关，它不仅是肾脏损害的结果，也是肾功能下降的原因。妊娠及其独特的生理适应性会受到肾脏滤过能力下降的影响。子痫前期是一种血管内皮疾病，CKD导致的内皮功能障碍会使其加重。由于疾病发病机制重叠，为尽量减少心血管损害，必须严格维持血压目标。此外，既往存在的肾功能不全对识别叠加的子痫前期构成挑战，这会改变孕期的管理策略。CKD患者的胎儿结局受高血压的影响很大。本综述有望有助于为患有CKD的孕妇制定有针对性的个体化高血压治疗方案，以改善妊娠结局并保留产后肾功能。
