Renal function assessment:

Renal dysfunction in a pregnant woman with T1DM is associated with an increased risk of adverse maternal and fetal outcomes, including an increased risk of preeclampsia. Mild preconceptional renal dysfunction manifesting only as microalbuminuria may worsen during pregnancy with greater amounts of proteinuria. However, the degree of worsening is typically both modest an reversible once pregnancy is completed so long as BP and blood Glu remain well controlled during pregnancy. More severe preconceptional renal dysfunction, as evidenced by a reduced GFR and elevated serum creatinine, can significantly deteriorate during pregnancy and may not be reversible.

R1.6a Suggest all women with diabetes considering pregnancy have their renal function assessed by measuring: 

• serum creatinine,
• urine albumin to creatinine ratio and
• e-GFR

before withdrawing contraceptive measures or start trying to conceive. (ungraded)

Is renal dysfunction recorded?