The problems you are having may indeed be due to your single kidney. When you have a kidney removed, the total amount of work done by your kidneys to clean your blood does not go down very much. The remaining kidney takes up the slack by perfusing the remaining glomeruli more. Pregnancy itself results in increased perfusion of the kidney. Over working a kidney can result in proteinuria. Most women have very successful pregnancies with a single kidney. Some develop complications.
You are at 31 weeks and do not seem very close to needing delivery due to your BP. Babies born at 32 weeks or greater do very well. Even if your condition progresses over time, you should expect a good outcome but possibly with a complicated course.
5 grams of proteinuria is NOT normal. Neither are BP's of 140/90. Given dBP's > 90 and proteinuria, you already have preeclampsia. I would expect the disease process to progress. We just do not know how fast it will progress. You could become sick next week; it could be several weeks.
To the extent that your proteinuria is due to the pregnancy, it should resolve. It may not resolve entirely; you may have some underlying renal condition. Postpartum, you might best see a nephrologist to evaluate your condition. Blood pressure drugs such as ACE-inhibitors can help reduce your proteinuria and preserve your kidney function if problems remain. (We generally do not use these in pregnancy). Current recommendations suggest that your non-pregnant BP's should be < 70.
Weekly visits with fetal monitoring would be appropriate. While you do not seem to be seriously ill right now, (and you may not become sick), you have a significant chance of rapidly evolving to severe preeclampsia.
Given your complex pregnancy condition, it would be perfectly appropriate to consult with a maternal fetal specialist. Listings of specialists are available at http://www.smfm.org/ and specialists that focus on hypertensive pregnancies are available at http://www.nasshp.com
Expert on Call
Information provided on this site is provided for informational purposes only and is not meant to substitute for the advice provided by your own physician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disorder, or prescribing any medication. The Preeclampsia Foundation presents all data as is, without any warranty of any kind, express or implied, and is not liable for its accuracy, for mistakes or omissions of any kind, nor for any loss or damage caused by a user's reliance on information obtained on the site. Professional opinions on this condition vary greatly. The Preeclampsia Foundation endorses no one course of treatment or "cure". Responses generated by our Experts to specific questions are based on information anonymously submitted to this site via email, are not based on a complete review of any patientÃƒÂ¢Ã¢â€šÂ¬Ã¢â€žÂ¢s medical records and should not be construed as the only reasonable expert response to the info submitted and/or the scenario described.
Do you have a burning question you just have to ask our Medical Board Experts about hypertensive pregnancies? Please email your question to firstname.lastname@example.org Keep in mind, however, that we won't be able to answer every question and our docs can't offer medical advice and won't be able to comment on specific medical cases.
2 posts • Page 1 of 1
I had a nephrectomy during my first pregnancy at 21 wks (as a result of kidney cancer) and no further complications - textbook pregnancy afterwards. Delivered at 40 wks with C-section due to breech. Now, in my second pregnancy, I am at 31 weeks and have suddenly had high BP (140/90) and protein in my urine (maybe predicted by my high hCG levels at quad screen test??). While on rest, protein was 5g/day and BP dropped to 128/78. OB thinks this is due to single kidney and might be "normal" for me, but I am suspicious as I had no problems the first time around. No sign of IUGR at this point. I am concerned about stressing my single kidney to point of permanent damage - are these values of concern?
Brendan 40w 3/21/00
Brendan 40w 3/21/00
Users browsing this forum: No registered users and 2 guests