skip to main content

CKD eGFR Decline Pregnancy — ESENeph MCQ

Instant feedback + full explanation. One question, done properly.

ModeratePregnancy & RenalCKD eGFR Decline PregnancyESENeph

A 35-year-old woman with CKD G3a from reflux nephropathy is 28 weeks pregnant. Her eGFR has declined from 55 to 42 during pregnancy. Is this expected?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: C — Some eGFR decline during pregnancy is common in women with pre-existing CKD G3-4 and does not always indicate permanent progression; post-partum recovery may occur but is unpredictable

In women with pre-existing CKD G3-4, pregnancy-related eGFR changes are variable. Unlike healthy women (who experience GFR increases), women with moderate-advanced CKD may experience eGFR decline during pregnancy from increased metabolic demand, haemodynamic stress, and disease activity. Post-partum, some recover toward baseline but irreversible progression occurs in a proportion (particularly those with heavy proteinuria or advanced CKD at conception). Close monitoring is essential but delivery decisions depend on the overall clinical picture, not eGFR alone.

Reference: UKKA 2019 – Pregnancy in CKD; Wiles et al 2019 – CKD and Pregnancy