- A 30 year female of Chronic nephritis/CRF had a live related renal transplant 1 year back. She seeks your advice regarding future pregnancy. She is receiving Prednisolone, Cellcept and cyclosporine as maintenance immunosuppression . Her BP is well controlled with Enalpril 5mg once daily.
a) How
would u assess her suitability of successful outline of pregnancy what advice
would you give?
b) What
if any modification in her current medication is required should she become
pregnant?
c) What complications are expected?
Answere: Assessment of suitability regarding
pregnancy and advice entails:
Assessment of her current renal
function, her urine detail report and her course post transplant sofar.
At least 1 year post‐transplantation
Stable renal function with creatinine
<2 mg/dl
No recent episodes of acute
rejection
BP ≤140/90 mmHg on medications
Proteinuria <500 mg/day
Prednisone ≤15 mg/day Azathioprine
≤2 mg/kg/day
Cyclosporin ≤4 mg/kg/day
Normal allograft ultrasound
b) Replace cellcept with
azathioprin and enalpril with methyldopa. Atenolol and metoprolol can also be
given. In severe hypertension nefidipine and hydralazine can be given.
d) Gestational
diabetes, preeclamsia, preterm labour .
Rate of uti more especially whose primarily
renal disease is secondary to Pyelonephritis.
