Hypertension and associated complications in pregnant women with chronic kidney disease

妊娠期慢性肾病患者高血压及其相关并发症

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Abstract

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.

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