Pregnancy and kidney disease

For women with kidney disease, it is possible to have a completely normal and uneventful pregnancy. However, you are at increased risk of blood pressure problems, worsening kidney function, smaller or premature babies, as well as other health problems. The severity of your kidney disease usually determines how likely it is for you to develop problems during pregnancy.

For men with kidney disease, sperm quality and count may be affected – especially as your kidney disease advances. A kidney transplant can restore this, but sometimes not back to normal levels.

Babies born to women with kidney disease or a transplant may be healthy or born premature or small. If you are pregnant, seek ongoing care from a high-risk pregnancy obstetrician if possible, to monitor how your baby is growing.

Transplant medicines that are considered safe in pregnancy do not seem to have long-term effects on a baby’s health. Breastfeeding is encouraged – very little gets into breast milk. If you’re on medication, consult your doctor about any potential impacts before getting pregnant.

For women on dialysis, there is a lower chance of conception. While such pregnancies are rare, they still occur, and outcomes have improved in recent years. In saying that, they are still very high-risk pregnancies and need specialised care.

Be careful about falling pregnant if you are on dialysis; this may be hard to detect as your periods may be irregular. Please take note that kidney disease does not protect you from falling pregnant. Contraception should always be a consideration for women with kidney disease (or a transplant) who are sexually active.

Men on dialysis may have a lowered sperm count and find it harder to conceive.

After transplantation, fertility usually increases as a patient’s health improves. However, it is recommended that women wait at least 12-24 months to become stable on anti-rejection medication before trying to become pregnant.

Some transplant medications are associated with adverse effects on the baby, so be sure to talk to your doctor before conceiving. In particular, women must use contraception while taking mycophenolate or a similar drug.

Often, medications are changed to make pregnancy safer, and although at higher risk, many transplant recipients around the world have given birth to healthy babies (and mother and child have remained well afterward).

A man’s fertility and sexual function often improves after transplantation, and this means his partner is more likely to get pregnant. Contraception may be required while planning the safest route to parenthood.

You may find more information on pregnancy and kidney disease in our handbook, Living with kidney failure.