Pregnancy in Patients with Diabetic Nephropathy

Background and Aim  To determine the influence of pregnancy on renal functions in patients with diabetic nephropathy and influence of diabetic nephropathy on pregnancy outcome. Methods  A prospective cohort study was carried out on 15 patients with diabetic nephropathy with pregnancy (group 1), 15 diabetic patients with diabetic nephropathy without pregnancy (group 2) and 15 pregnant diabetic patients without nephropathy (group 3). Patients with diabetic nephropathy with serum creatinine less than 3 mg% were involved. Renal function tests were done every 3 months for 18 months. Pregnancy outcome and complications were recorded. Results  Comparing group 1 and group 2 shows significant difference as regards percent increase in serum creatinine, percent change in GFR and percent increase in urinary proteins. Comparing group 1 and group 3 shows significant difference as regards rate of toxemia of pregnancy, preterm delivery and small for age babies. Mean blood pressure, GFR deterioration and mean HbA1c are the main determinant of most complications. Conclusions  Pregnancy leads to deterioration in renal functions in patients with diabetic nephropathy with elevated serum creatinine; also the presence of diabetic nephropathy increases pregnancy unfavorable outcomes. Special care should be given to blood pressure control, blood sugar control and control of renal condition.