Nephrotic syndrome in pregnancy

Posted By  hfhs.md.db on April 15, 1999 at 15:28:16
Topic Area: Pregnancy - Abnormal
  I am trying to find out more about nephrotic syndrome in pregnancy.  I was diagnosed with NS two years ago and am currently 27 weeks pregnant.  So far everything has been going well, however at 16 weeks I did have to go on blood pressure medication, but it has helped and my blood pressure is back to normal.  I have been told that I will probably not carry to term.  I will be going on maternatity leave  at the end of April.  I am looking for someone who has maybe been through this or who can give me additional info.

[hfhs.md.db]

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Nephrotic syndrome can be caused by a variety of conditions that impact the kidney. The risk to pregnancy in many cases is more related to the cause of the nephrosis rather than the proteinuria(nephrotic syndrome) itself. For example, nephrotic syndrome secondary to systemic lupus erythematosus would have a very different outlook than due to other causes.
That being said, the majority of cases of nephrotic syndrome are due to "minimal change disease" or IgA nephropathy. If renal function is preserved (normal creatinine clearance on a 24 hour urine collection), most of these pregnancies will be uncomplicated. The hypertension you have developed is somewhat worrisome and certainly merits close watching.
The biggest risk is the development of pre-eclampsia, which can only be effectively treated ultimately by delivery (induction of labor or cesarean). Women often develop greater than normal edema (swelling) due to the loss of so much protein into the urine and subsequent loss of colloid oncotic pressure in the blood, which leads to leaking from the capillaries.
Hope this helps.

[miche21]

A related discussion, Pre-eclampsia and having on functional kidney was started.