Table 2.

Some clinical questions waiting for answers regarding pregnant women with CKD. BP—blood pressure.

Question	Key Points
What is the interaction between the different renal determinants of pregnancy outcomes (hypertension, proteinuria, and kidney function)?	Each of these factors has been independently associated with adverse pregnancy-related outcomes; their hierarchy, if any, is not known.
Are there specific differences between the various kidney diseases?	Because of the high heterogeneity of CKD, little is known about the effect different kidney diseases have on pregnancy.
What is the role of initial kidney tissue damage in hypertensive or diabetic pregnancies?	Risk factors for preeclampsia are almost all the same as risk factors for the development of CKD. Initial kidney damage may be the final pathway to adverse pregnancy outcomes.
What is the best BP target in CKD or diabetic pregnancies?	The target blood pressure probably depends on control policy. If this is true, stricter controls should allow for safer normalisation.
What is the best frequency of controls in the different CKD stages?	Even if CKD is presently acknowledged as a risk factor in pregnancy, the best policies for follow-up and controls have not yet been established.
When and how should dialysis be started in pregnancy?	The recent literature shows improved results in dialysis patients. When to start dialysis in pregnancy has not been established. An early start may be an option, but it is in contrast with the data suggesting that a later start is safer in all other cases.
What is the role of nutritional management of CKD pregnancies?	Nutritional management can probably compensate for deficits and balance the metabolic derangements of CKD, but its role has to be established.
What should be done in the case of ‘forbidden’ potentially teratogen medications in pregnancy?	There is a wide variety of risks and phenotypes, and the echographic findings are usually available too late.
How should the indications for managing CKD pregnancies be adapted to low- to medium-income countries?	Most of the indications for the care of pregnancies in CKD and related diseases have been defined in high-income countries. Their adaptation to low- to medium-income countries are difficult if not impossible.