LN and CKD increases the risk of adverse pregnancy outcomes. Pregnancy of a lupus patient is a challenge to the nephrologist. Professor Okpechi explains the three categories of LN, i.e. active disease, relapsing remitting disease, quiescent disease. This presentation explains the reproductive physiology in pregnancy and in women with CKD and explores the endocrine effects of CKD on the hypothalamic-pituitary-ovarian axis Professor Okpechi discusses symptoms of pregnancy that can mimic lupus activity and provides information on medication management in pregnant lupus patients. He discusses the various guidelines, stressing that all recommend the involvement of a multidisciplinary team from the onset. He discusses the difficulties of compliance and the KDIGO recommendations for treatment of LN patients, including counselling to delay pregnancy until a remission of LN has been achieved. Professor Okpechi discusses pregnancy outcomes in non-lupus CKD and presents on a systematic review of the subject. He concludes with a case presentation on the subject.