Pre-pregnancy counseling for women with chronic kidney disease.

Pre-pregnancy counseling should be available for all women with chronic kidney disease (CKD) so that conception occurs at the right time in the course of their disease and while they are on the right medications, with the aims of minimizing risks for both mother and fetus. Key areas to consider are the factors which are associated with worse prognosis and the influence of underlying kidney conditions and their treatment, in particular lupus nephritis, advanced renal impairment and transplantation. This experience-based review provides a guide to clinicians managing women with CKD, before and during their pregnancy.