Table 2—

Stages of the evolution of diabetic nephropathy and common effects on pregnancy

Stages of kidney damage*GFRAlbuminuriaPregnancy effect
Hyperfiltration (a)>150<30 mg/dayUnknown
Microalbuminuria 1>9030–299 mg/dayIncreased preeclampsia
Macroalbuminuria 1>90≥300 mg/dayIncreased preeclampsia
Early nephropathy 260–89TPE ≥500 mg/dayIncreased risk of fetal growth restriction
Moderate CKD 330–59Massive proteinuriaPerinatal complications likely
Severe CKD 415–29Less proteinuriaDelay pregnancy to after transplant
Kidney failure 5<15Dialysis
  • *

    * There may be overlap between GFR and albuminuria groupings. In the second level and beyond, kidney damage is defined as abnormalities on pathologic, urine, blood, or imaging tests (refs. 2 and 190). Table modified from references 2 and 188–190. GFR: creatinine clearance quantified as ml/min per 1.73 m2. CKD, chronic kidney disease; TPE, urinary total protein excretion.