Pregnancy and the kidney, hypertensive disorders in pregnancy

1. Big picture

Pregnancy is a physiological stress test for the kidneys. A healthy kidney adapts by increasing renal plasma flow and glomerular filtration rate (GFR), lowering serum creatinine and tolerating mild physiological hydronephrosis. A diseased kidney may decompensate, and pregnancy-specific disorders such as preeclampsia, HELLP syndrome, thrombotic microangiopathy, acute fatty liver of pregnancy, pyelonephritis, and postpartum acute kidney injury may appear.

The examiner wants you to recognize four patterns:

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