In pregnancy, glomerular filtration rate (GFR) and effective renal plasma flow (ERPF) increase to levels approximately 50% to 80% above nonpregnant levels. The increments occur shortly after conception and persist throughout the second trimester, with some reduction in late pregnancy. There is no accelerated growth akin to compensatory hypertrophy. The increased excretion of glucose and other nutrients in as well uric acid and protein is related in part to altered tubular function. These changes in renal physiology are so marked that nonpregnant norms cannot be used for the management of pregnant women. Cognizance of all these alterations is essential if kidney problems in pregnancy are to be suspected, detected, and managed correctly.
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