In pregnancy, the kidneys are enlarged, the renal pelvis, calyces and ureters are dilated, the glomerular filtration rate and renal plasma flow increase by 35-50%, and the urine protein quantification increases to 0.3-0.5 g/d, while the upper limit of urine protein quantification in a non-pregnant normal person is 0.15 g/d. Because of the increased glomerular filtration rate and renal plasma flow, the blood creatinine levels will decrease. Therefore, a blood creatinine level >72ummol/L in a pregnant patient is considered abnormal renal function. Due to decreased uric acid reabsorption during pregnancy, there are lower blood uric acid levels throughout pregnancy, with the upper limit of normal blood uric acid levels being approximately 4.5 mg/dl in mid to late pregnancy, as well as glycosuria and amino aciduria. The bicarbonate level (CO2CP) can be as low as 19-20 mmol/L in pregnancy, but usually it is 20-22 mmol/L. In pregnancy, the bicarbonate level can be as low as 19-20 mmol/L due to the stimulation of respiratory center by progesterone hormone, which leads to respiratory alkalosis. In some cases, the urinary protein quantification can be 1-3-4 g/24h, not because of an increase in kidney disease, but because of changes in the kidneys during pregnancy. damage is not certain. Can pregnancy accelerate the progression of diabetic nephropathy Since we basically do not see pregnant women with type 2 diabetes, the experience with mainly type 1 diabetes has been reported in the limited literature that pregnancy does not exacerbate diabetic nephropathy, but again after follow-up observations some pregnant women are found to progress to end-stage uremia. And there is a worrying issue of increased mortality in these pregnant women. Why is that? Because once progression to diabetic nephropathy occurs, these patients can develop asymptomatic or as yet unknown coronary artery disease by age 30, which is the leading cause of death in pregnant patients with diabetic nephropathy. Does pregnancy have an effect on the course of IgA nephropathy It has been observed that pregnancy itself does not exacerbate IgA nephropathy. In general, the outcome of pregnancy in patients with kidney disease is related to the basal blood pressure and renal function at the beginning of pregnancy. The overall outcome of pregnancy is mostly good for blood creatinine levels below 1.5 mg/dl (126 μmol/L), and the lower the creatinine level, the better the prognosis. Even with mild or moderate renal insufficiency, if their blood pressure is completely normal, the outcome will be good. Effects of kidney disease on pregnant women: In general, pregnancy in women with kidney disease increases the risk of pre-eclampsia. And once pre-eclampsia occurs, severe renal insufficiency occurs in 60-70% of women, which can cause preterm labor, low birth weight, and obstetric complications. Even if a pregnant woman does not have pre-eclampsia, but has progressive renal disease, she is prone to preterm delivery and intrauterine fetal growth retardation. And diabetic nephropathy with decreased glomerular filtration rate has high perinatal mortality in the fetus, frequent preterm delivery in pregnant women, and low birth weight in newborns.