Understanding the relationship between reproductive health and kidney function is important to provide holistic care for people living with kidney disease. Chronic kidney disease (CKD) has negative impacts on both male and female fertility owing to factors including inflammation, hormonal dysregulation, reduced ovarian reserve, reduced sperm quality and sexual dysfunction. However, pregnancy is achievable for most cisgender women with kidney disease, including kidney transplant recipients and patients on dialysis. CKD in pregnancy is associated with health risks to the mother and child, including increased risk of progression of kidney disease, hypertensive complications of pregnancy, and neonatal complications including fetal growth restriction, preterm birth and stillbirth. However, with appropriate pre-pregnancy counselling, fertility assessment and support, health optimization, and evidence-based antenatal care, the majority of patients will achieve a good outcome. Medication safety should be reviewed before and during pregnancy and lactation, weighing the risk of disease flare against potential adverse effects on the offspring. Important areas for further research include the optimal timing of delivery and the short- and long-term cardiovascular and renal impacts of pregnancy in patients with CKD, as well as long-term kidney and cardiovascular outcomes in their offspring.

了解生殖健康与肾功能之间的关系对于为肾病患者提供整体护理非常重要。慢性肾病 （CKD） 对男性和女性的生育能力都有负面影响，原因包括炎症、荷尔蒙失调、卵巢储备减少、精子质量下降和性功能障碍。然而，大多数患有肾病的顺性别女性，包括肾移植受者和透析患者，怀孕是可以实现的。妊娠期 CKD 与母婴健康风险有关，包括肾脏疾病进展风险增加、妊娠高血压并发症以及新生儿并发症，包括胎儿生长受限、早产和死产。然而，通过适当的孕前咨询、生育能力评估和支持、健康优化和循证产前保健，大多数患者将获得良好的结果。应在怀孕和哺乳期之前和期间审查用药安全性，权衡疾病发作的风险与对后代的潜在不利影响。进一步研究的重要领域包括 CKD 患者的最佳分娩时间、妊娠对心血管和肾脏的短期和长期影响，以及其后代的长期肾脏和心血管结局。