Introduction: The kidneys perform excretory, regulatory, hormonal and metabolic functions. However, their function may change in the presence of various medical conditions. The degree of renal function loss can be determined via the estimation of the clearance rate of glomerular filtration rate (GFR) which determines the volume of blood that is filtered by the kidneys per unit of time. In chronic kidney disease (CKD),the clearance rate of glomerular filtration rate decreases below 60 mL/min/1.73 m2. However, when a female patient with chronic kidney diseases conceives, the renal plasma flow and the clearance rate of glomerular filtration rate increase by 40% to 50% or by 50% to 85%. Purpose: The purpose of the diploma thesis is to present the influence of chronic kidney disease on the very pregnancy and the characteristics of pregnancy in women with chronic kidney disease. Methods: A descriptive reseach design was employed. A systematic review of Slovene and foreign scientific literature relating to pregnant women with chronic kidney disease was conducted. Literature search was conducted in four foreign electronic databases, i.e. MEDLINE, ScienceDirect, CINAHL and PubMed, and in two Slovene bibliographic-catalogue databases, i.e. COBBIS and DiKul. Results: The presence of chronic kidney disease in pregnant women has been associated with an increased risk of complications during the very pregnancy, during labour, and in the postnatal period, therefore these patients need the support of healthcare professionals who can provide counselling and guidance in the preconception period, during the very pregnancy, and in the postpartum period. Women with advanced chronic kidney disease need to undergo early hemodialysis replacement therapy which reduces the adverse effects of uremic toxins on the growth and development of the fetus. Hemodialysis is conducted on a daily basis, with each session lasting for several hours at a time, which places a significant burden on the pregnant patient, so the latter needs to be provided with health education which should be delivered by a qualified nurse. Discussion and conclusion: Advanced chronic kidney disease reduces the chance of a successful conception and pregnancy outcome and the delivery of a healthy fetus, so women with chronic kidney disease are advised not to delay the first pregnancy. Younger women have a lower risk of complications than their older counterparts, and their renal impairment progresses at a much slower pace. Since a female patient experiences additional distress during the very pregnancy, the assigned healthcare professionals and the members of the multidisciplinary team (i.e. the team of obstetricians and nephrologists) should stimulate a supportive and trusting relationship in order to relieve the distress. Professional advice, support during the transition to intensive hemodialysis, regular health assessment, awareness of the lifestyle of the pregnant woman, a high level of empathy and a few words of encouragement enhance the well-being of the patient and increase the level of trust and satisfaction during the very treatment, which ensures
a successful pregnancy outcome.
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