Chronic Kidney Disease, more frequent in women
Chronic Kidney Disease (CKD) has a big impact on morbidity and mortality, though it is poorly recognized. The main function of the kidneys is to filter blood, dispose waste and excess of water turning it into urine, as well as keeping a chemical balance in the body. Kidneys help control blood pressure and to produce hormones. In KDS, kidneys cannot perform their functions properly, leading to waste accumulation in the body, creating various health problems.
Epidemiologic studies show that CKD pre-dialysis is more frequent on women than men. This is associated with reduced fertility and a higher risk of a detrimental pregnancy like preeclampsia, fetal growth, and premature delivery.
An article published on January 2018 by Nature Reviews Nephrology magazine mentions various studies. One of a sample with 778 women with CKD, big cohort studies with 504 women with CKD; and a meta-analysis with 23 studies with 1514 pregnant women with CKD included. The studies showed that these women with CKD have adverse maternal and neonatal results than women without CKD.
There are additional factors associated to negative results of pregnancy that are independent to kidney disease, like preexisting hypertension, transplant, lupus nephritis, proteinuria, and preeclampsia. Most kidney diseases can be asymptomatic during the first stages and cannot be detected until later. This affection can be the result of other kidney diseases, diabetes, hypertension, etc. These are the main causes of CKD on developed countries.
It is sustained that CKD on women of reproductive age has a risk on reduced fertility and adverse pregnancy. It is recommended that women with CKD that wish to get pregnant plan it through because unplanned pregnancies are associated with higher risks. It is also necessary to seek help on contraception for women with CKD that do not wish to have children.
Contraceptives with progesterone, like pills, IUD or subdermal implants can be used safely in women with CKD, including dialysis patients or transplant receptors.
Anemia, vitamin D deficiency, and hypertension can develop as a consequence of CKD and can also complicate pregnancy. Medication during pregnancy always comes with a risk, as well as a benefit. Many medications used on CKD bring higher benefits during pregnancy, as long as teratogens and fetotoxic medications are avoided.
Reviewers: Brenda Giselle Álvarez Rodríguez (Public Health Research Unit), and Cassandra Saldaña Pineda (Knowledge Management Unit).
- Article: “Women’s health and kidney disease”. Nature Reviews Nephrology 14, 139 (2018).
- Article: “Reproductive health and pregnancy in women with chronic kidney disease”. Nature Reviews Nephrology volume 14, pages 165–184 (2018).
- Article: “Kidneys and women’s health: key challenges and considerations”. Nature Reviews Nephrology volume 14, pages 203–210 (2018).
- American Pregnancy Association.