Can women with cystic kidney disease have a safe pregnancy?

Question

Hi doctor,

I am 34 and just found out I have cystic kidney disease after having severe back pain that sent me to the emergency room last week. The CT scan showed multiple cysts on both kidneys, with some being quite large - the biggest one is 8 centimeters according to the radiologist. My blood pressure has been creeping up over the past year and is now 155/95 mm Hg, even though I am young and healthy otherwise. Kidney function tests showed creatinine at 1.4 and eGFR of 65, which the nephrologist said is concerning for my age.

Family history is positive - my mother had polycystic kidney disease and needed dialysis in her 50s before getting a kidney transplant. I am getting married in six months, and we want to start trying for a baby right away, but I am now scared about passing this cystic kidney disease to our children. The genetic counsellor said there is a 50 percent chance each pregnancy could be affected.

Pregnancy might make kidney function worse since I already have some damage. Can women with cystic kidney disease have safe pregnancies? What medications are safe to control blood pressure while trying to conceive?

Thanks.

Answer 1

Hi,

Welcome to icliniq.com.

I can understand your concern.

I am deeply concerned about your worries. Women with multiple cysts in the kidney can conceive without issue. However, according to your case, the CT (computed tomography) scan report shows multiple cysts in both kidneys, the largest of which is eight centimeters in size. There is also an elevation of creatinine level, indicating that the damage to the kidney from the cyst has begun. You need to consult a urologist for further management because, according to the CT scan, the size of the cyst is severe.

You need to complete all baseline investigations, complete blood count, liver function test, renal function test, random blood sugar, viral markers, ECG (electrocardiogram), and chest X-rays. Discuss with the patient that the size of the cyst is moderate and needs to be treated first, then you can plan pregnancy after complete treatment, and start tablet folic acid 5 mg till the completion of the first trimester.

I hope this information is helpful to you.

Thanks.