Abstract： Objective:To explore the impact of abnormal renal ultrasound image on renal function and pregnant outcome in pregnancies with chronic kidney disease(CKD).Methods:One hundred cases of pregnancies with CKD complicated with normal renal ultrasound image (group A) and thirty-four cases of patients complicated with abnormal renal ultrasound image (group B) were enrolled. The data on clinical features and pregnant outcomes were collected.Results:(1) Statistical analysis of these results revealed there were significant differences in the average systolic blood pressure[(125.6±15.2)mmHg vs (145.4±23.2)mmHg, t=-4.649] and diastolic blood pressure[(79.4±11.7)mmHg vs (93.9±16.3)mmHg, t=-4.782] and the media of 24-hour proteinuria[880.8 mg vs 4519.5 mg, Z=-5.052], serum creatinin[53.0 μmol/L vs 96.0 μmol/L, Z=-5.832], Blood urea nitrogen[3.7 mmol/L vs 6.2 mmol/L, Z=-4.938] and serum uric acid[320.0 μmol/L vs 452.0 μmol/L, Z=-4.285] between two groups (P<0.001). (2) There was a significant difference in the media of serum β2-microglobulin[2.0 mg/L vs 3.7 mg/L, Z=-5.779] between the two group. For the urinary proteins, there were significant differences in the media of urinary microalbumin[255.5 mg/L vs 1425.0 mg/L, Z=-3.699], immunoglobulin G[35.4 mg/L vs 112.5 mg/L, Z=-3.198], transferrin [21.6 mg/L vs 148.5 mg/L, Z=-4.132], α1-microglobulin[14.9 mg/L vs 34.4 mg/L, Z=-3.868], β2-microglobulin[0.4 mg/L vs 5.0 mg/L, Z=-5.439] and retinol-binding protein[0.4 mg/L vs 3.7 mg/L, Z=-4.960] between two groups. (3) Over 70.6%(24/34) of patients in group B were superimposed with PE, while only 20% of patients in group A were superimposed with PE. And there was a significant difference between the two groups in the incidence of PE (χ2=29.443, P<0.001). The mean delivery time for patients in group A was (35.9±6.1) gestational weeks, which had a highly significant difference from the mean delivery time for patients in group B of (31.8±6.9) gestational weeks(t=3.289, P=0.001). (4)In follow-up visits, media of fetal weight varied significantly between the two groups (Z=-3.906, P<0.001). The proportion of FGR or SGA onset for patients in Group B was 17.6%, while the proportion of FGR or SGA onset for patients in Group A was only 2.0%(χ2=8.454, P=0.004). (5)There was a positive correlation between abnormal renal ultrasound image and blood pressure, serum β2-microglobulin, creatinine, uric acid, proteinuria, incidence of PE and pleural effusion, and ascites (P<0.005). There was a negative correlation between abnormal renal ultrasound images and the delivery time and weight of the fetus (P<0.001).Conclusions:Abnormal renal ultrasound may be one of the sensitive signals of adverse clinical features and pregnant outcomes. It is suggested that every pregnancy with chronic kidney disease should actively accept a renal ultrasound examination during pregnancy.