Parameter | Alteration | Clinical relevance |
Kidney size | Approximately 1 cm longer on radiograph.[1] | Size returns to normal postpartum.[2] |
Ureteral dilation | Resembles hydronephrosis on sonogram (more marked on right).[3] | Can be confused with obstructive uropathy; retained urine leads to collection errors; renal infections are more virulent. |
Renal function | Glomerular filtration rate and renal plasma flow increase approximately 50%.[4] | Serum creatinine decreases during normal gestation; creatinine >0.8 mg/dL (>72 micromol/L) should be considered abnormal; protein, amino acid, and glucose excretion all increase.[5-7] |
Acid-base balance | Hyperventilation and respiratory alkalosis due to progesterone stimulation of respiratory center. Renal bicarbonate excretion increases appropriately.[7] | PCO2 decreases to 27 to 32 mmHg; serum bicarbonate decreases to 22 mmol/L; pH remains in high-normal range.[7] |
Plasma osmolality | Osmotic thresholds for AVP release and thirst decrease; metabolic clearance of AVP increases. | Serum osmolality decreases 10 mOsm/L (serum Na approximately 5 mEq/L) during normal gestation; increased placental metabolism of AVP may cause transient diabetes insipidus during pregnancy. |
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