Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Year in Review
  • Published:

Health equity in 2022

Insights into the impact of pregnancy on kidney disease

Nature Reviews Nephrology volume 19, pages 79–80 (2023)Cite this article

Subjects

Studies in 2022 have advanced knowledge of pregnancy outcomes in kidney donors and transplant recipients as well as the long-term risks associated with hypertensive disorders of pregnancy. These findings should be used to support shared decision-making and appropriate care of women with or at risk of kidney disease.

Key advances

  • Living kidney donors have a low absolute risk of adverse pregnancy events4; discussion of risk should be individualized and desire for future pregnancy should not be a barrier to donation.

  • Pre-donation pregnancy complications were not associated with increased cardiovascular risk or reduced long-term kidney function in kidney donors; however, donors should receive ongoing follow-up for kidney disease, hypertension and diabetes5.

  • In the general population, hypertensive disorders of pregnancy conferred a 2–3-fold increased risk of incident chronic kidney disease that was observed within 3 years of delivery and exacerbated by racial and sociodemographic factors6.

  • Pregnancy after kidney transplantation can be complicated but has a high likelihood of excellent outcomes; preconception kidney function is the main driver of pregnancy outcomes and graft loss7.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: Roadmap to pregnancy with kidney disease.

References

  1. Qi, A. & Hladunewich, M. A. Nephrology and women’s health post-Roe v. Wade: we must do better. Nat. Rev. Nephrol. 18, 741–742 (2022).

    Article  Google Scholar 

  2. American Society of Transplantation. AST Statement on Supreme Court’s Overturning of Roe v. Wade https://www.myast.org/ast-statement-supreme-courts-overturning-roe-v-wade (2022).

  3. American Society of Nephrology. ASN Statement on Supreme Court Decision in Dobbs v. Jackson Women’s Health Organization https://www.asn-online.org/news/2022/0625-ASN_Statement_on_Do.pdf (2022).

  4. Pippias, M. et al. Pregnancy after living kidney donation, a systematic review of the available evidence, and a review of the current guidance. Am. J. Transplant. 22, 2360–2380 (2022).

    Article  Google Scholar 

  5. Helgeson, E. S. et al. Pre-kidney donation pregnancy complications and long-term outcomes. Transplantation 106, 2052–2062 (2022).

    Article  CAS  Google Scholar 

  6. Malek, A. M. et al. Hypertensive disorders of pregnancy with and without prepregnancy hypertension are associated with incident maternal kidney disease subsequent to delivery. Hypertension 79, 844–854 (2022).

    Article  CAS  Google Scholar 

  7. Gosselink, M. E. et al. A nationwide Dutch cohort study shows relatively good pregnancy outcomes after kidney transplantation and finds risk factors for adverse outcomes. Kidney Int. 102, 866–875 (2022).

    Article  Google Scholar 

  8. Jesudason, S. & Piccoli, G. B. Pregnancy outcomes after kidney transplantation: the challenges of success. Kidney Int. 102, 697–699 (2022).

    Article  Google Scholar 

  9. Tong, A. et al. Nephrologists’ perspectives on gender disparities in CKD and dialysis. Kidney Int. Rep. 7, 424–435 (2021).

    Article  Google Scholar 

Download references

Acknowledgements

E.H. (Co-investigator) is supported by the Hospital Research Foundation 2021 Women’s Health Grant awarded to S.J. (Chief Investigator).

Author information

Authors and Affiliations

  1. Australia and New Zealand Dialysis and Transplant Registry (ANZDATA), South Australian Health & Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia

    Erandi Hewawasam

  2. Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, South Australia, Australia

    Erandi Hewawasam & Shilpanjali Jesudason

  3. Central Northern Adelaide Renal and Transplantation Services (CNARTS), Royal Adelaide Hospital, Adelaide, South Australia, Australia

    Shilpanjali Jesudason

Authors
  1. Erandi Hewawasam
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Shilpanjali Jesudason
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shilpanjali Jesudason.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hewawasam, E., Jesudason, S. Insights into the impact of pregnancy on kidney disease. Nat Rev Nephrol 19, 79–80 (2023). https://doi.org/10.1038/s41581-022-00663-z

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41581-022-00663-z

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing