Figure 1012

Management of chronic renal disease during pregnancy is best accomplished with a multidisciplinary team of specialists. Preconception counseling permits the explanation of risks involved with pregnancy. Patients should understand the need for frequent monitoring of blood pressure and renal function. Protein restriction is not advisable during gestation. Salt intake should not be severely restricted. When renal function is impaired, modest salt restriction may help control blood pressure. Blood pressure should be maintained at a level at which the risk of maternal complications owing to elevated blood pressure is low. Patients should be monitored closely for signs of preeclampsia, particularly in the third trimester.

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