Renal Disorders in Pregnancy

This is from the pre-2009 curriculum.

Understand how pregnancy affects renal physiology in normal individuals and those with pre-existing renal disease (including those on renal replacement therapy)
Knows the potential risks of pregnancy to the mother and foetus in patients with chronic kidney disease (including dialysis) and renal transplant
Understands how to manage medical issues in patients with pre-existing renal disease, dialysis or a renal transplant during a pregnancy with particular emphasis on minimisation of the risk to mother and foetus
Understand the importance of appropriate drug therapy in pregnancy and knows the adverse effects on the foetus of commonly used drugs in patients with renal disorders
Recognise those renal disorders that are inherited and be able to explain the inheritance pattern

Able to counsel a patient with renal disease, on dialysis or with a renal transplant about the risks and implications of pregnancy and acts to minimise risks to mother and foetus
Safely investigates de-novo renal disease in pregnancy or a deterioration in renal function in a pregnant transplant patient
Manages hypertension appropriately in pregnancy
Modifies medication including immunosuppressive drugs appropriately during pregnancy or in a women planning pregnancy
Recognises and manages the renal consequences of pre-eclampsia and acute renal failure in pregnancy and the puerperium
Explains the inheritance of genetic disorders

Works closely with Obstetricians, midwives and pharmacists in the management of patients both before conception, during pregnancy and post-partum
Discusses sensitively the risks and implications of pregnancy to a patient and their partner/family to enable the women to make an informed choice
Recognises the need for genetic counselling in inherited kidney disorders

Resource	Type	Star rating
Renal disease and pregnancy (Medscape) - Poor, feels long but is superficial on important areas and varies from UK practice.	Online review	2
http://www.doctors.net.uk/Targetting/Article.aspx?areaid=15&articleid=3215&msrc=top needs log in to exact location (I can't find it at all ... is it Liz Lightstone's lecture - a summary has been withdrawn and I can't see lecture either.)	Interactive case
Renal Disease in Pregnancy RCOG (Davison, Nelson-Piercy, Kehoe and Baker) 2008. Explores the most up-to-date evidence on all aspects of diagnosis and management in women with renal problems before, during and after pregnancy. Chapters describe many of the issues likely to be faced in clinical practice, providing valuable information for all healthcare professionals working in this field. Library, or Â£80: comprehensive rather than a summary.	Book	5
NHS CKS on Hypertension in Pregnancy - excellent, well-presented and readable recommendations with evidence, not specifically renal. Tip-top first read for trainees or update for experienced clinicians.	Evidence review	4

The Renal Association