Ch 48 Pregnancy And Kidney Disease Flashcards
Kidney biopsy should be avoided in what weeks of AOG
Between 23 and 26 weeks gestation
Postpone pregnancy until lupus activity us quiescent for how many months
6 months
What is the MC complication of pregnancy in transplant patients?
Due to?
Hypertension
Due to combination of underlying medical conditions and the use of CNIs
Fertility in women with ESRD may be improved by intensive hemodialysis, how many hours per wk?
36 hours per wk
How long should you switch MMF to azathioprine prior to conception?
3 months
KT results in return to normal hormonal function and fertility withing how many months
6 months
Physiologic changes in pregnancy
1. Creatinine level decreases to?
2. GFR increases by how many % above baseline?
3. RBF increases by ?
4. Sodium decreases by?
Decrease GFR due to?
Decrease Na due to?
- 0.5-0.6 mg/dL
- 40% -50% above baseline ( 150-200ml/min)
- 80% above baseline
- 4-5meq/L
- Early - increase RPF
2nd half - increase filtration fraction - Due to hGC and relaxin
Increase proteinuria in pregnancy due to?
(3)
- Due to increase GFR
- Inc permeability pf GBM
- Dec tubular reabsorption of filtered protein
Repispiratory alkalosis by the end of 1st tri due to?
Progesterone- direct stimulation of respi drive by inc sensitivity to Co2
Diabetes insipidus in pregnancy due to?
Tx?
Inc vasopressinase —> hydrolyses ADH
Dec ADH —> polyuria, polydipsia
Tx: Deaminoa8D- arginine vasopressin (not destroyed by vasopressinase)
Timing of pregnancy after transplantation
conception could be safely considered early as 1 year posttransplant for women on stable doses of nonteratogenic immunosuppressive agents
with normal renal function (Cr < 1.5 mg/dL and urinc protein excretion of <500 mg/day)
no concurrent fetotoxie infections (such as cytomegalovirus)
and with no rejection episodes within the past year
Case of Fever, oliguria. Graft tenderness, or deterioration in renal function
Management?
Acute rejection
Do biopsy then high dose steroids
