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Fertility and kidney disease – and how to seek help

Kidney Disease is often called the silent killer. One in three Australians is at increased risk of developing kidney-related disease, and 53 are dying with kidney related disease every single day, yet most are tragically unaware they have it until it is too late.

For women, many are surprised to learn that kidney disease can increase their risk of infertility and miscarriage, and it’s a shock to hear that more than 2.5 million Australian women do not know that they’re in a high-risk group for developing kidney disease, or that it can comprise their fertility.

Fertility and kidney disease – and how to seek help

What is kidney disease?

Kidney disease occurs when your kidneys, which are two bean-shaped organs that act as your body’s waste filtration system, are damaged in some way and are not filtering a person’s blood properly.

So, why is fertility affected by Chronic Kidney Disease?

Fertility can be affected because Chronic Kidney Disease can cause a lot of hormonal changes, particularly when the disease is quite advanced. Sometimes women with severe kidney failure such as those needing dialysis may experience irregular periods or no periods at all, so it’s very rare for these women to get pregnant and even if they do, there is a high chance of early miscarriage.

Kidneys also work at 150% capacity by 12 weeks of pregnancy, so for a woman in the early stages of pregnancy and who has kidney disease, that’s a lot of added pressure on her kidneys. The placenta, which feeds the baby, may not grow properly, and the baby may be small and be born early.

Women who conceive a child while on dialysis or following a kidney transplant are at increased risk of premature delivery and having babies with small birth weight, so its important that women discuss family planning with their doctor.

Fertility issues and issues in pregnancy raise a much larger question about who is at risk of developing kidney disease, and what can be done to prevent it.

Kidney disease can literally affect anyone. It’s a common misconception that kidney disease only affects older people, when in fact, even small children can be diagnosed with kidney disease.

Are you one of the ‘1 in 3’ at risk of developing kidney disease?

Australians at risk of developing chronic kidney disease include those who:

  • have diabetes
  • have high blood pressure
  • have established heart problems such as heart failure or heart attack
  • have had a previous stroke
  • have a family history of kidney failure
  • are obese with a body mass index (BMI) of 30 or higher
  • smoke
  • have a history of acute kidney injury
  • are 60+ years
  • are of Aboriginal and Torres Strait Islander origin.

Preventing kidney disease – and where to see help?

It’s important to take care of your kidneys, and some of our recommendations are:

  • Get your blood pressure checked regularly and make sure it stays below the levels recommended by your doctor.
  • If you have diabetes make sure you monitor your blood glucose levels and stay within your targets.
  • Lead an active, healthy lifestyle and maintain a healthy weight.
  • If you have ever had problems with blood pressure and diabetes in pregnancy, make sure you see your doctor and get followed up later in life.

It’s also important to note that if caught early, chronic kidney disease is very treatable and in some cases can even be reversed entirely. This is why we’re encouraging all Australians to know their risk profile and, if they fall into a high-risk group, to get their kidneys checked by a general practitioner.

Will all women with kidney disease have fertility issues?

Each woman’s situation is individual, but with careful planning and specialised care, many women with kidney disease can have successful pregnancies. In Australia, on average 30-50 pregnancies occur each year in women receiving dialysis or a transplant. A life-saving kidney transplant can often also restore fertility and give these women a new chance at motherhood.

Worldwide, thousands of babies have been born after a kidney transplant, which is a wonderful outcome for these women and their families.

However, early detection and treatment of kidney disease (so women don’t get to the stage of needing dialysis or a transplant), is the best option to increase the likelihood of having children and leading a healthy life.

About Dr Shilpa Jesudason

Dr Shilpa Jesudason is Clinical Director at Kidney Health Australia.

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