Renal Complications in Pregnancy Preceding Glomerulonephropathy Diagnosis

Oliverio, Andrea L.; Zee, Jarcy; Mariani, Laura; Reynolds, Monica L.; O’Shaughnessy, Michelle M.; Hendren, Elizabeth; Alachkar, Nada; Herreshoff, Emily; Rizk, Dana V.; Nester, Carla; Steinke, Julia; Twombley, Katherine; Hladunewich, Michelle A.

doi:10.1016/j.ekir.2018.10.012

Cited by 14 publications

(11 citation statements)

References 12 publications

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“…9 In a retrospective study of women with glomerulopathies who had a pregnancy prior to their diagnosis, those who reported deterioration of renal function, worsening proteinuria, worsening blood pressure control and/or pre-eclampsia diagnosis during pregnancy were diagnosed with glomerulopathy sooner than women who had reported an uncomplicated pregnancy. 10 Together with our findings these studies suggest that pregnancy or delivery may exacerbate or cause hyperfiltration injury, and reveals otherwise undiagnosed renal disease.…”

Section: Comparison To Other Studiessupporting

confidence: 82%

Renal biopsy findings during and after pregnancy

et al. 2019

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Section: Comparison To Other Studiessupporting

confidence: 82%

Renal biopsy findings during and after pregnancy

et al. 2019

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“…63,64 A review of women diagnosed with GN showed that many patients presented during pregnancy with complications, and this may be an opportunity for healthcare providers to act early in the disease process. 65 Contraception is also an important consideration. RASi and many GN therapies are known to be Category X (potentially teratogenic or embryotoxic) medications.…”

Section: Research Recommendationsmentioning

confidence: 99%

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Rovin¹,

Adler²,

Barratt³

et al. 2021

Kidney International

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S28 Introduction S30 Summary of recommendation statements and practice points S88 Chapter 1: General principles for the management of glomerular disease S115 Chapter 2: Immunoglobulin A nephropathy (IgAN)/immunoglobulin A vasculitis (IgAV) S128 Chapter 3: Membranous nephropathy S140 Chapter 4: Nephrotic syndrome in children S153 Chapter 5: Minimal change disease (MCD) in adults S161 Chapter 6: Focal segmental glomerulosclerosis (FSGS) in adults S172 Chapter 7: Infection-related glomerulonephritis S187 Chapter 8: Immunoglobulin-and complement-mediated glomerular diseases with a membranoproliferative glomerulonephritis (MPGN) pattern of injury S193 Chapter 9: Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis S207 Chapter 10: Lupus nephritis S231 Chapter 11: Anti-glomerular basement membrane (Anti-GBM) antibody glomerulonephritis S235 Methods for guideline development S243 Biographic and disclosure information S254 Acknowledgments S256 ReferencesThis guideline is published as a supplement supported by KDIGO. The development and publication of this guideline are strictly funded by KDIGO, and neither KDIGO nor its guideline Work Group members sought or received monies or fees from corporate or commercial entities in connection with this work. The opinions or views expressed in this professional education supplement are those of the authors and do not necessarily reflect the opinions or recommendations of the International Society of Nephrology or Elsevier. Dosages, indications, and methods of use for products that are referred to in the supplement by the authors may reflect their clinical experience or may be derived from the professional literature or other clinical sources. Because of the differences between in vitro and in vivo systems and between laboratory animal models and clinical data in humans, in vitro and animal data may not necessarily correlate with clinical results.

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“…[1][2][3][4][5][6][7][8][9][10] Conversely, pregnancy in patients with already diagnosed FSGS is known to have a higher risk for complications, including preeclampsia, preterm delivery, and increases in proteinuria. [11][12][13][14][15][16] Hyperfiltration stress, which is likely to increase in pregnancy, has been identified as a potential, albeit not confirmed, risk factor for the development of an overt clinical picture of FSGS. This can be an issue in women born with very low birth weight, a population known to have a reduced nephron number and to be particularly prone to developing FSGS.…”

Section: Introductionmentioning

confidence: 99%

Collapsing Lesions and Focal Segmental Glomerulosclerosis in Pregnancy: A Report of 3 Cases

Guillén

Silva

González

et al. 2019

American Journal of Kidney Diseases

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The relationship between focal segmental glomerulosclerosis (FSGS) and pregnancy is complex and not completely elucidated. Pregnancy in patients with FSGS poses a high risk for complications, possibly due to hemodynamic factors, imbalance between angiogenic and antiangiogenic factors, and hormonal conditioning. Although poor clinical outcomes associated with collapsing FSGS are common outside of pregnancy, the prognosis during pregnancy is not well documented. We report 3 patients who developed collapsing FSGS during pregnancy, 2 of whom had presumed underlying FSGS. Two patients underwent biopsy during pregnancy, and 1, during the puerperium. None of the 3 patients improved spontaneously after delivery, and 1 experienced a rapid deterioration in kidney function and proteinuria after delivery. Aggressive immunosuppressive therapy led to a full response in 1 case (without chronic lesions) and to partial responses in the remaining 2 cases. These cases suggest that collapsing lesions should be considered in patients with FSGS who develop a rapid increase in serum creatinine level or proteinuria during pregnancy and that these lesions may at least partially respond to treatment.

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Renal Complications in Pregnancy Preceding Glomerulonephropathy Diagnosis

Cited by 14 publications

References 12 publications

Renal biopsy findings during and after pregnancy

Renal biopsy findings during and after pregnancy

KDIGO 2021 Clinical Practice Guideline for the Management of Glomerular Diseases

Collapsing Lesions and Focal Segmental Glomerulosclerosis in Pregnancy: A Report of 3 Cases

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