Women and kidney health: conclusions from a Kidney Disease: Improving Global Outcomes (KDIGO) Controversies Conference.
A KDIGO Controversies Conference on Women and Kidney Health calls for integrating sex and gender into every stage of kidney care across the lifespan, and affirms that successful pregnancy is possible at all severities of CKD — including on dialysis or with a transplant — when managed with proactive counseling and multidisciplinary planning.
Background
The conference was convened to identify key sex- and gender-related issues in kidney care, define practices to optimize care for women with kidney disease, and set research priorities, addressing the influence of sex and gender on diagnosis, risk assessment, prognosis, and treatment across puberty, reproductive health, and menopause.
Key conclusions
CKD is a risk factor for adverse pregnancy outcomes across every type and severity of kidney disease. All women of reproductive age with known CKD should be counseled on contraception, ideal pregnancy timing, maternal-fetal risks, fertility treatment, medication management, and termination. Successful pregnancy is achievable across all CKD severities, including in women on dialysis or with a kidney transplant, and should be managed with a multidisciplinary plan tailored to the kidney disease and the presence of impaired function, hypertension, and proteinuria.
Clinical implications
Systematic assessment of blood pressure, proteinuria, and kidney function in all pregnancies would help diagnose CKD and detect acute kidney injury. Structured follow-up after pregnancy-related AKI, preeclampsia, or other hypertensive disorders of pregnancy is important, as these may reflect undiagnosed CKD and carry implications for future cardiovascular health.
Category
KDIGO
Source
Kidney International
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