Successful Pregnancy and Delivery in a Chronic Renal Failure Patient with Membranoproliferative Glomerulonephritis and Preeclampsia-related Nephrotic Syndrome.

慢性肾功能衰竭患者膜增殖性肾小球肾炎和先兆子痫相关肾病综合征成功妊娠和分娩一例。

• 影响指数: 1.282
• 发表时间: 2024 Jul 15
• 来源期刊: Intern Med
• DOI: 10.2169/internalmedicine.1972-23
• PMID: 38008458
• 文章类型: Case Reports
• 中科院分区: Q3
• 方向: 医学
• 作者列表: Nakai K,Sato K,Nohara N,Takagi M,Kihara M,Ueda S,Gohda T,Suzuki Y

关键词: chronic kidney disease; membranoproliferative glomerulonephritis; nephrotic syndrome; preeclampsia; pregnancy

Mesh: Humans; Female; Pregnancy; Glomerulonephritis, Membranoproliferative / complications diagnosis; Adult; Nephrotic Syndrome / complications diagnosis etiology; Pre-Eclampsia / diagnosis; Kidney Failure, Chronic / complications etiology; Pregnancy Complications / diagnosis; Pregnancy Outcome

Abstract

A 37-year-old woman with chronic kidney disease (CKD) stage G4 with membranoproliferative glomerulonephritis was hospitalized for nephrotic syndrome and hypertension due to superimposed preeclampsia at 27 weeks into her third pregnancy. Proteinuria did not worsen significantly after pulse steroid therapy. Delivery was induced at 30 weeks\' gestation due to the maternal renal function and fetal growth. No obvious fetal complications other than preterm delivery were observed. In this case, we successfully managed a high-risk patient with membranoproliferative glomerulonephritis complicated by advanced CKD, nephrotic syndrome, and hypertension, which are independent risk factors for pregnancy complications.

摘要

一名37岁的患有慢性肾脏疾病（CKD）G4期膜增生性肾小球肾炎的妇女在第三次怀孕27周时因合并先兆子痫而因肾病综合征和高血压住院。脉冲类固醇治疗后蛋白尿没有明显恶化。由于母体肾功能和胎儿生长，在妊娠30周时诱导分娩。除早产外，未观察到明显的胎儿并发症。在这种情况下,我们成功地治疗了一个高危患者的膜增生性肾小球肾炎并发晚期CKD,肾病综合征,和高血压，是妊娠并发症的独立危险因素。