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J Nephropathol. Inpress.
doi: 10.34172/jnp.2026.28708
  Abstract View: 14

Original Article

Physiological impact of pregnancy on renal function; a prospective cohort study

Saad Mashkoor Waleed 1* ORCID logo, Abdul-Hassan Mahdi Salih 2 ORCID logo, Saba Sabeeh Hussain 3 ORCID logo

1 Department of Physiology, College of Pharmacy, University of Alkafeel, Najaf, Iraq
2 Department of Physiology, College of Medicine, University of Thi-Qar, Nasiriyah, 64001, Iraq
3 Department of Anatomy, Histology and Embryology, College of Medicine, University of Thi-Qar, Nasiriyah, Iraq
*Corresponding Author: Saad Mashkoor Waleed, Email: saad.alzaiy@alkafeel.edu.iq

Abstract

Introduction: Pregnancy induces substantial physiological adjustments that extend to renal function, driven by changes in blood volume, hormonal activity, and metabolic demands that alter the normal behavior of key biochemical markers. Understanding how these renal parameters evolve across gestation is essential for distinguishing healthy physiological adaptation from early signs of renal impairment.

Objectives: This study aimed to examine trimester‑specific changes in renal function within a prospective cohort of pregnant women to clarify the expected trajectory of renal biomarkers during normal pregnancy.

Materials and Methods: The study employed a prospective cohort design conducted at a maternity teaching hospital in Nasiriyah, Iraq, enrolling 49 first‑trimester singleton pregnant women who were followed from January 2024 to January 2025 to assess longitudinal renal changes. Eligible participants were singleton pregnant women who provided informed written consent. Demographic and obstetric data were collected at enrollment, and venous blood samples were obtained at the end of each trimester to measure blood urea and serum creatinine using standardized biochemical procedures. Renal biomarkers were compared across trimesters to evaluate alterations in kidney function during pregnancy.

Results: The study included 49 pregnant women with a mean age of 30.22 ± 8.25 years. The results demonstrated progressive alterations in renal biomarkers across pregnancy, with both blood urea and creatinine levels indicating a steady and statistically significant rise from the first to the third trimester (P<0.05).

Conclusion: Pregnancy is associated with a steady and significant increase in renal biomarkers across trimesters. These findings highlight the importance of considering trimester‑specific changes when evaluating maternal renal function.



Implication for health policy/practice/research/medical education:

In this study, we found that pregnancy produces a gradual and measurable shift in renal physiology, reflected in the steady rise of key biochemical markers as gestation progresses. The upward trajectory of these biomarkers signals a dynamic process of renal adaptation in which filtration and solute‑handling mechanisms evolve in parallel with the physiological transformations of pregnancy. This pattern reinforces the concept that maternal kidney function is not static but undergoes a predictable, trimester‑dependent modulation that must be considered when evaluating renal health during pregnancy.

Please cite this paper as: Waleed SM, Salih AHM, Hussain SS. Physiological impact of pregnancy on renal function; a prospective cohort study. J Nephropathol. 2026;x(x):e28708. DOI: 10.34172/jnp.2026.28708.

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Submitted: 15 Feb 2026
Revision: 09 Mar 2026
Accepted: 03 Apr 2026
ePublished: 15 Apr 2026
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