Women, kidney disease, and pregnancy

Adv Chronic Kidney Dis. 2013 Sep;20(5):402-10. doi: 10.1053/j.ackd.2013.06.004.

Abstract

Several glomerular diseases may occur in women of childbearing age. Pregnancy in such patients should be planned when the disease has been in remission for a minimum of 6 months to minimize maternal and fetal complications. Immunosuppressive agents should be optimized before conception to include those that are safe for pregnancy. The complexity of medical management when caring for these patients calls for a multidisciplinary team approach consisting of a nephrologist, rheumatologist, obstetrician, and pharmacist. This review will address the physiological changes of pregnancy that may affect glomerular disease presentation, activity, and diagnosis; specific glomerular diseases primary and secondary to systemic diseases in the context of pregnancy; fetal and maternal complications and long-term effects; diagnosis and differential diagnosis; and treatment strategies that are considered relatively safe with respect to fetal intrauterine exposure.

Keywords: Glomerular disease; Kidney disease; Preeclampsia; Pregnancy; Proteinuria.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Antiphospholipid Syndrome / diagnosis
  • Antiphospholipid Syndrome / therapy
  • Atypical Hemolytic Uremic Syndrome
  • Diabetic Nephropathies / diagnosis
  • Diabetic Nephropathies / therapy
  • Female
  • Glomerulonephritis / diagnosis
  • Glomerulonephritis / therapy
  • Hemolytic-Uremic Syndrome / diagnosis
  • Hemolytic-Uremic Syndrome / therapy
  • Humans
  • Immunosuppressive Agents / therapeutic use
  • Kidney Diseases / diagnosis*
  • Kidney Diseases / therapy
  • Lupus Nephritis / diagnosis
  • Lupus Nephritis / therapy
  • Nephrosis, Lipoid / diagnosis
  • Nephrosis, Lipoid / therapy
  • Pregnancy
  • Pregnancy Complications / diagnosis*
  • Pregnancy Complications / therapy
  • Scleroderma, Systemic / diagnosis
  • Scleroderma, Systemic / therapy
  • Vasculitis / diagnosis
  • Vasculitis / therapy

Substances

  • Immunosuppressive Agents