Renal Failure In Pregnancy

Renal failure in pregnancy

INTRODUCTION

It is called renal insufficiency when the kidneys are not able to correctly filter the toxins and blood waste substances that are why when the kidneys do not work well, an alteration is generated in all the functions that are their own and the manifestations Both clinics and analytical, will depend on the degree of the loss of renal function and if it is an acute or chronic problem.

Pregnancy is a physiological event of women who has an impact on multiple organs and systems, the kidneys are not exempt from these changes, so renal structures suffer a series of modifications that often alter their normal functioning.

The risk of developing renal failure is almost as high in women as in men, being a little greater in women. According to some studies, renal failure has an average prevalence of 14% in women.

This disease attacks those that are in gestation because the collecting system, calices, renal pelvis and ureters is dilated, which can persist until the end of the puerperium; caused by the relaxing action of progesterone on smooth muscle.

Renal failure in pregnancy causes a negative effect because not only the mother would be affected, unfortunately babies experience intrauterine growth delay, low birth weight and fetal death

The purpose of this essay is to determine the factors that affect the development of this disease in pregnant women, we will carry out an investigation using a deductive methodology with information collected from various articles, to learn more about this disease because it is very important, put on that we know how renal insufficiency in pregnancy affecting serious problems for the mother in gestation and also for their baby and even those who are thinking of conceiving one.

DEVELOPING

The studies carried out by Hippocrates, showed that changes in the composition of the urine were decisive to know if something was wrong with some internal organs, when analyzing the urine it was observed that the greatest damage was found in the kidneys since these They are responsible for generating urine, then when studying it we can observe the health status of the kidneys and if they are affected by the malfunction of other organs in general.

The first references of the kidney and their pathologies date back to 1500 to.C, Hippocrates de Cos was the first to know and describe various subtle macroscopic changes in urine, which reflected certain specific diseases in different organs, mainly of the kidney.

The kidneys are vital organs in our bodies when leaving waste, excess water and controlling the balance of acidity of our blood. Renal failure is the gradual loss of kidneys capacities to perform these essential functions, which can be caused by high blood pressure, diabetes, obesity, smoking and other risk factors.

One in three people in the general population has a higher risk of renal failure and although it is estimated that 10 percent of people around the world have chronic kidney disease, estimates suggest that nine out of ten are not aware of their condition. 

The period of pregnancy is usually the most important stage of each woman, however, the changes suffered by the organism during it make it susceptible to some complications. These complications may occur due to a health problem prior to pregnancy or develop a condition during the same. Among the most common diseases that develop or complicate with pregnancy, kidney problems are locked.

During the pregnancy stage, a woman can develop various conditions in her health, regardless of how she had been before pregnancy, of course the complications before pregnancy would make the task even more difficult, but given the case that the pregnant person generates a disease during pregnancy implies that your health was affected precisely by this same process.

During the gestation period, women can participate in minor diseases such as infections to urinary tract that would have any consequence; even acute kidney diseases that imply risks for both the fetus and the pregnant woman.

It is important to know how , there are a few risks that can bring both for the carrier of the disease in question, and for their embryo.

The first step to know if the kidneys are working well is to analyze urine in search of proteins. These are good for human beings, but they must be in the blood, not in urine. If they are in the urine, it means that the kidneys are not filtering how they should.

Nephrology is a broad field of medicine that aims to study the anatomy of the kidneys and their function, the doctor who takes care of this area is known as nephrologist. On the other hand, the renal stage does not show signs or symptoms, so it is important that a checkup due to renal disease is performed if it has the main risk factors: diabetes, high blood pressure, heart disease or genes, which would be tests of Blood, urine and image.

If we refer to the causes caused by this disease, the concrete cause caused by this situation is unknown, in general evaluate the number of cases that are recorded from this disease, but there are still two possible causes for renal failure In pregnancy, the most common are diabetes and arterial hypertension, if any of these diseases occur before or during pregnancy, the patient may get to suffer from renal failure, however, we have concrete knowledge about the symptoms that are from this, some of these symptoms can be:

• Changes in frequency, quantity and color of urination.
• Fluid retention, which in turn can cause swelling and feeling of fatigue.
• Metallic flavor in the mouth and breath to ammonia, caused by the increase in urea in saliva.
• Arterial hypertension.
• Nausea and vomiting.

Once we have perceived the symptoms, the recommended thing would be to open the way to the appropriate treatments for the control of the disease. Hemodialysis is used in these cases, since it is used to replace renal function in women suffering from this disease during pregnancy.

Hemodialysis is the first choice method to replace renal function in women with chronic or acute renal failure during pregnancy or postpartum. Perinatal complications are frequent, however, knowledge of the adequacy of the technique in the medical treatment of patients can contribute to the reduction of their presentation and improve perinatal results.

It should be noted that the application of hemodialysis in a patient with pregnancy can lead contribute to the obtaining better and long term results.

You also have to take into account a very important factor and that is that complications in renal failure in pregnant women, not only focuses on disease as such, but we also have the fact that this disease leads to others for their complications , in the case of pregnant women, it has been recorded that they have more prone to suffer from renal failure, other diseases such as arterial hypertension or even preeclampsia that is generated precisely for the previous reason, when a pressure is diagnosed High arterial before pregnancy this disease may be complicated during pregnancy.

Pregnant women suffering from renal failures are more likely to suffer from arterial hypertension, preeclampsia, eclampsia and even death. Even those suffering from a mild renal disease can cross complications such as anemia or malnutrition during pregnancy.

Renal diseases (ER) can be subdivided into acute or chronic. For Flores, Chung, Veletánga, & Carbo. Acute renal failure "is a syndrome characterized by a sharp decrease (hours, weeks) of renal function and subsequently nitrogen retention". Complications such as: heart failure, pericarditis, arrhythmias, high digestive hemorrhage, pulmonary edema, pneumonia, adult respiratory distress, adults, confusion, coma, among others, among others. 

On the other hand, a chronic renal disease is known is characterized by the constant variation in renal structure or function, this implies that the functioning of the kidneys is abruptly affected and if it is passed to the structure change phase it can Cause damage that you are irreversible and cause the death of the patient and the fetus in gestation, even so it is estimated that chronic renal diseases affect approximately 10% of the world’s population, making cases of pregnant women scarce still.

During a pregnancy/postpartum in a healthy woman, renal function presents important changes, both anatomical and physiological that determine the findings in the analyzes performed and are essential to understand the complexity of the pathophysiological alterations that may occur during pregnancy.

Finally we enter a more technical part and analyze what anatomy is or how this system works during the disease, in which area it occurs and others. We are aware that the organs in charge or rather, affected by the disease are the kidneys, in the human kidney two differentiated areas can be distinguished, a lighter external area called cortex and another internal that is called renal marrow.

The kidneys are two twin bonds shaped like a bean and approximate size of a fist. They are located under the rib cage, in the middle part of the back, above the waist, one on each side of the dorsal spine. Each supports a small but crucial cap of the endocrine tissue called the hood of the adrenal gland, which produce the important steroid hormones of the body. The right kidney is approximately a centimeter lower than the left. To mark it on the surface of the body.

We also have certain physiological changes that can occur during pregnancy, then we will show a list of these changes according to the Havanera Magazine of Medical Sciences, 2016:

• Increase in the dependent progesterone renal size, with return to normal postpartum
• Dilation of the renal pelvis, calices and ureteral; Vesical incomplete emptying due to secretion.
• Decreased beaches (creatinine, urea and uric acid) due to increased plasma flow with increased glomerular filtrate: typical glomerular hyperfiltration, (minimal proteinuria, glucosuria and amino aciduria may appear).
• Positive sodium balance (hyponatremia).
• Positive calcium balance: high vitamin D; Metabolic alkalosis (HCO3 and pco2 diminished).
• Decrease in blood pressure (pressure) due to decreased peripheral resistances.
• Compression of the ureters by the growing uterus: it can increase the risk of your registration in special if lithiasis or app.

CONCLUSION

In conclusion, statistics show that renal insufficiency attacks women more, although the specific cause caused by this anomaly is not yet known, however pregnancy does not worsen renal disorders.

Women with kidney disease who are considering pregnancy and starting a family must have access to the specialist’s health council to help them with the process. It is important that they are aware of the potential risks and the ways in which they can reduce complications and perfect the prognosis for their child

The most critical or dangerous point in women’s life is pregnancy, likewise another important danger that has to do with urinary and renal infections that, according to the expert, in sexually active women are very frequent because they are accompanied by relationships Sexual, "if they are not treated on time, progress and can become as severe as a pyelonephritis that could lead to the kidney to its total deterioration".

Most women with the gently diminished renal function before conceiving have a normal pregnancy without harmful effects, although there is a slightly increasing risk of complications, those with a more advanced disease are at a growing risk of complications for their baby and some, determined for these dialysis patients, they can be fatal for the child.

This is why society in general should have more knowledge of the importance of screening in those patients with risk factors, since early detection is the key, both in men and women, to avoid the progression of kidney disease and The development of cardiovascular complications. 

The best way to prevent this type of inconvenience is monitoring in the different stages of childbirth. Even today, especially in developing countries, there are pregnant women who do not receive the corresponding medical care in those periods. For this reason, the risk factors that can predispose to conditions such as this are not detected and the symptoms that they present are properly evaluated.

Finally, it is possible to emphasize the importance of investigating, this is essential because it helps us to obtain knowledge about the environment that surrounds us, creates solutions to our problems and improves our quality of life.