This Toolkit aims to provide evidence-based educational materials. This toolkit is designed for nephrologists and health professionals wishing to increase their knowledge, as well as to teach others effectively on these topics. Whether you deliver a lecture to peers, train residents, or educate multidisciplinary teams, these resources are adaptable to various settings and audiences.
By equipping nephrologists with the tools needed to understand, manage, and treat women with CKD who are planning to conceive or become pregnant, we aim to improve maternal and fetal outcomes and advance care on a global scale. By using and sharing this toolkit, we hope to inspire more clinicians to become champions of obstetric nephrology.
The Faculty and Trainers of the ISN Train the Trainer Program for Pregnancy and Kidney Disease, developed this curriculum, 2023-24. The curriculum aligns with modules within the Pregnancy and Kidney Disease Toolkit released in 2025. The curriculum content and modules will be regularly updated and expanded. The content in the modules is for General Nephrologists, Nephrology Trainees, Nurses and Allied health professionals.
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Help shape the next generation of Obstetric Nephrology experts
We are now accepting expressions of interest to join the 2025–2026 trainer cohort for the ISN Train the Trainer Program – Pregnancy and Kidney Disease.
Selected trainers will play a key role in advancing the field and further developing the ISN Pregnancy and Kidney Disease Toolkit.
Shilpanjali Jesudason
Australia
Michelle Hladunewich
Canada
Dominique Martin
Australia
Dominique is Professor of Health Ethics and Professionalism in the School of Medicine at Deakin University. Her research focuses on ethical issues in organ and tissue donation and transplantation and in nephrology, and on professionalism in healthcare. Dominique currently represents Oceania on the Council of the international Transplantation Society and has served as a consultant to the World Health Organization and the Australian Organ and Tissue Authority. She is also a member of the joint ethics task force of ISN-ASN-ERA, Chair of the Asia Pacific Bioethics Education Network, an Associate Editor of Transplantation, and a founding member of the Doha International Academy for Organ Donation and the Declaration of Istanbul Custodian Group.
Alejandra Orozco Guillen
Mexico
Giorgina Barbara Piccoli
France
Valerie Luyckx
Switzerland
Ghada Ankawi
Saudi Arabia
Nishanta Tangirala
Australia
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An introduction to the field of obstetric Nephrology, the evolution overtime, and future priorities and directions - by Prof Michelle Hladunewich
Open to view video.
Overview of the ISN train the trainer program for pregnancy and kidney disease and launch of the ISN Toolkit of educational resources for pregnancy and kidney disease by Prof Shilpa Jesudason
Open to view video.
Saudi Arabia - experiences of the ISN train the trainer program for pregnancy and kidney disease, and future directions by A/Prof Ghada Ankawi
Open to view video.
India - experiences of the ISN train the trainer program for pregnancy and kidney disease, and future directions by Prof Divya Bajpai
Open to view video.
ISN Pregnancy and Kidney Disease Toolkit Overview (January 2025)
Open to download resource.
Open to download resource.
This curriculum was developed by the Faculty and Trainers of the ISN Train the Trainer Program for Pregnancy and Kidney Disease, 2023-24. The curriculum aligns with modules within the Pregnancy and Kidney Disease Toolkit released in 2025.
The curriculum content and modules will be regularly updated and expanded.
The content in the modules is for General Nephrologists, Nephrology Trainees, Nurses and Allied health professionals.
ISN TTT Pregnancy and CKD Education Principles (December 2024)
Open to download resource.
Open to download resource.
1. Essential Skills for Lecturing
2. Lecture Preparation
3. How do we improve clarity?
4. Interactive Lectures
5. Webinar making tips
ISN TTT Fertility and Contraception (January 2025)
Open to download resource.
Open to download resource.
1. Fertility and Kidney Disease
a. Assessing Fertility in women with CKD – clinical history and basic investigations
b. Sexual dysfunction in women with CKD
c. Fertility and cyclophosphamide
2. Assisted Reproductive Technologies
a. Fertility preservation options in women with CKD
b. Assisted reproduction options
c. Preimplantation Genetic Testing
3. Contraception management in Women with CKD
a. Purpose and benefits of contraception
b. Safe contraceptive options for women with CKD
c. Risks associated with hormonal contraceptives in CKD
4. Counselling for unplanned pregnancy
a. Options for safe termination of pregnancy in CKD
ISN TTT Preconception counselling basics (January 2025)
Open to download resource.
Open to download resource.
1. Approach to Preconception Counselling
a. Frameworks for counselling
b. Ethical considerations in counselling
c. Assessing reproductive goals and undertaking shared decision-making
2. Preparing for pregnancy
a. overview of risk stratification and management principles
b. Explaining risks to patients
ISN TTT Pregnancy in Dialysis Recipients (January 2025)
Open to download resource.
Open to download resource.
1. Epidemiology of pregnancy in dialysis recipients (haemodialysis and peritoneal dialysis)
2. Preconception Counselling for patients with advanced CKD and receiving dialysis
3. Pregnancy Outcomes in women receiving dialysis
4. Managing Dialysis in Pregnancy
a. Dialysis regimens and adjustments during pregnancy - hemodialysis and peritoneal dialysis
b. Residual kidney function and dialysis intensity in pregnancy
c. Fluid management in dialysis recipients during pregnancy
d. Managing Nutrition, Anemia and Bone / Mineral Metabolism in dialysis recipients during pregnancy
e. Managing Dialysis Access in pregnancy
f. Home dialysis and pregnancy
5. Post-partum management
6. Ethical issues – dialysis resourcing
ISN TTT Kidney Transplantation and Pregnancy (December 2024)
Open to download resource.
Open to download resource.
1. Kidney allograft Accommodation to pregnancy
2. Fertility post-transplantation
a. Epidemiology of pregnancy post-kidney transplant – birth rates
3. Risks and outcomes of pregnancy post-transplant
4. Preconception Counselling in Transplant Recipients
a. General approaches and concepts
b. Ethical considerations in pregnancy counselling
5. Contraception post-kidney transplant
6. Risk factors for adverse pregnancy outcomes
a. Stratifying risk and preparing for pregnancy
7. Pregnancy Outcomes in Kidney Transplant Recipients
a. Maternal and Fetal outcomes
b. Graft function and Graft loss during and after pregnancy
8. Pregnancy management in Kidney transplant recipients
a. Immunosuppressive Management in Pregnancy
b. Evaluating graft dysfunction in pregnancy
c. Infections during pregnancy – CMV and UTI
ISN TTT Pregnancy Related Acute Kidney Injury (PR-AKI) (April 2025)
Open to download resource.
Open to download resource.
1. Epidemiology of PR-AKI – global perspective
- Definitions and Diagnostic challenges for PR-AKI
2. Aetiology of Pregnancy-Related AKI and risk factors
3. Maternal and Fetal Outcomes of PR-AKI
4. Risk Assessment for PR-AKI – antenatal and peri-partum
5. Management of PR-AKI
- Supportive management – general approaches
- Treatment of specific causes
- Indications for dialysis
- Indications for therapeutic plasma exchange
6. Longer term sequelae after PR-AKI and follow up
ISN TTT Postpartum Follow-up and Care (May 2025)
Open to download resource.
Open to download resource.
1. The post-natal period and early post partum care
- Recovery of kidney function, breastfeeding, contraception
- Neonatal wellbeing and nephrogenesis
2. Short-medium term followup
- Blood pressure, diabetes, weight management, psychological, nutrition, medication management
- Infant development
3. Long-term Follow-up
- Cardiovascular and Renal Risks for mothers
- Follow-up after PR-AKI
- Preterm or complicated birth and long term outcomes for infants
- Future pregnancy planning
ISN TTT Management of Pregnancy Hypertension and Preeclampsia (May 2025)
Open to download resource.
Open to download resource.
Impact Survey
5 Questions
