Dr. Bonnie Richardson is an Associate Professor of Medicine at the University of Saskatchewan and a nephrologist with the Saskatchewan Health Authority in Regina. She has completed fellowships in both Internal Medicine and Nephrology with the Royal College of Physicians and Surgeons of Canada. Her areas of expertise include kidney disease in pregnancy, therapeutic plasma exchange, and chronic illnesses in Indigenous populations. She is a strong advocate for patient-focused care and health equity.
Q: What made you decide to specialize in treating pregnant women with kidney disease?
BONNIE RICHARDSON: My interest started during my training when I saw the direct impact that chronic kidney disease (CKD) had on maternal and fetal outcomes. Many pregnant women with CKD experience issues conceiving or experience unpleasant symptoms during pregnancy. I saw that there was an urgent need for innovation in this area, and I’ve dedicated my work to this mission for over 20 years now. I’m incredibly proud of the difference our work has made in the lives of so many women with CKD who’ve been able to deliver healthy babies.
Q: What are the risks of developing kidney disease during pregnancy?
BONNIE RICHARDSON: A woman’s body goes through so many changes during pregnancy, putting stress on all major organs, including the kidneys. If a woman has already been diagnosed with CKD, the health risks can be higher depending on how severe the condition is. Women in stages 1-2 who have mild kidney disease with normal blood pressure might not experience issues in pregnancy. On the other hand, women with stages 3-5 CKD are at higher risk of preeclampsia or high blood pressure, preterm birth, and fetal growth issues. Regardless of the stage of CKD, continuous monitoring is crucial to prevent complications and ensure the best outcomes for the mother and baby.
Q: What management strategies or treatment do you typically apply to pregnant women with kidney disease?
BONNIE RICHARDSON: Management of kidney disease in pregnant women requires a full team of nephrologists, OBGYNs, perinatologists, and neonatologists. We incorporate strategies like blood pressure monitoring, kidney function monitoring through blood and urine tests, dietary management, and prescribing of safe medications for both the mother and baby. For women with advanced kidney disease, we would also address delivery timing and whether dialysis or a kidney transplant might be needed. The ultimate goal is to optimize both maternal and fetal health, aiming for the safest possible pregnancy and delivery.
Q: How do you provide emotional support to patients through the challenges of kidney disease during pregnancy?
BONNIE RICHARDSON: We create a supportive and understanding environment where women feel comfortable expressing their fears and concerns. This begins with open and honest communication about their condition and potential pregnancy outcomes. We educate them, explaining everything in clear, accessible language, empowering them with knowledge. We also connect patients with support groups and mental health professionals who specialize in perinatal care and chronic illness. Providing continuity of care with a consistent medical team also helps build trust and reduce anxiety. Ultimately, we aim to reassure them that they are not alone and that we are partners in their journey, offering medical expertise and compassionate support.
Q: What recent research efforts have improved the management or outcomes for pregnant women with kidney disease?
BONNIE RICHARDSON: We’ve recently made some great progress in understanding preeclampsia in women with kidney disease, and in diagnosing it much sooner. New tests are helping us spot at-risk patients sooner, which lets us act early with preventive measures and stop serious problems. There are also much safer medications for women with kidney transplants, which leads to more successful pregnancies. There are new studies with improved methods of controlling blood pressure in pregnant women with kidney disease. For the Saskatchewan Health Authority in particular, our approach to teamwork between doctors has created a more comprehensive approach to patient care, with experts in kidney disease, pregancy, and newborn care all providing support.
