2020, Number 1
<< Back Next >>
Rev Nefrol Dial Traspl 2020; 40 (1)
Focal segmental glomerulosclerosis after pregnancy complicated with preeclampsia and acute renal injury. Case report
Arellán-Bravo L, Valencia-Rodríguez J, Sánchez- Pérez L, Mayor-Balta F
Language: Spanish
References: 17
Page: 46-50
PDF size: 153.94 Kb.
ABSTRACT
We describe the case of a 35-year-old patient,
who experienced preeclampsia and oliguric acute
renal injury during her last pregnancy, requiring
intervention by emergency cesarean section and
dialysis support with a total of 16 hemodialysis
sessions; she responded favorably.
Four months after discharge, she developed
nephrotic syndrome, so she was hospitalized for
better management and a thorough etiologic
research. Support measures were taken with no
need for renal replacement therapy; secondary
lesions were ruled out and a renal biopsy was
performed. The pathological study concluded
that it was a focal segmental glomerulosclerosis,
in its perihilar variant.
The patient responded favorably during her
hospitalization and when discharged, she was
summoned to continue management by external
consultation. The appearance of nephrotic
syndrome months after pregnancy may suggest
the presence of an underlying glomerulopathy or
de novo glomerulopathy.
REFERENCES
Goldenberg RL, Culhane JF, Iams JD, Romero R.Epidemiology and causes of preterm birth. Lancet. 2008;371(9606):75-84.
Brown MA, Lindheimer MD, de Swiet M, Van AsscheA, Moutquin JM. The classification and diagnosis ofthe hypertensive disorders of pregnancy: statementfrom the International Society for the Study ofHypertension in Pregnancy (ISSHP). HypertensPregnancy. 2001;20(1):IX-XIV.
Zhou Y, Damsky CH, Fisher SJ. Preeclampsia isassociated with failure of human cytotrophoblasts tomimic a vascular adhesion phenotype. One cause ofdefective endovascular invasion in this syndrome? JClin Invest. 1997;99(9):2152-64.
Kwiatkowski S, Kwiatkowska E, Rzepka R, KurkiewiczV, Mikołajek-Bedner W, Torbè A. Development of afocal segmental glomerulosclerosis after pregnancycomplicated by preeclampsia: case report andreview of literature. J Matern Fetal Neonatal Med.2016;29(10):1566-9.
Cornelis T, Odutayo A, Keunen J, Hladunewich M.The kidney in normal pregnancy and preeclampsia.Semin Nephrol. 2011;31(1):4-14.
Lafayette RA, Druzin M, Sibley R, Derby G, MalikT, Huie P, et al. Nature of glomerular dysfunction inpre-eclampsia. Kidney Int. 1998;54(4):1240-9.
Hennessy A, Makris A. Preeclamptic nephropathy.Nephrology (Carlton). 2011;16(2):134-43.
Henao DE, Mathieson PW, Saleem MA, Bueno JC,Cadavid A. A novel renal perspective of preeclampsia:a look from the podocyte. Nephrol Dial Transplant.2007;22(5):1477.
Son GH, Kim JH, Hwang JH, Kim YH, Park YW,Kwon JY. Urinary excretion of nephrin in patients withsevere preeclampsia. Urinary nephrin in preeclampsia.Hypertens Pregnancy. 2011;30(4):408-13.
Sugimoto H, Hamano Y, Charytan D, CosgroveD, Kieran M, Sudhakar A, et al. Neutralizationof circulating vascular endothelial growth factor(VEGF) by anti-VEGF antibodies and soluble VEGFreceptor 1 (sFlt-1) induces proteinuria. J Biol Chem.2003;278(15):12605-8.
Garovic VD, Wagner SJ, Petrovic LM, Gray CE, HallP, Sugimoto H, et al. Glomerular expression of nephrinand synaptopodin, but not podocin, is decreasedin kidney sections from women with preeclampsia.Nephrol Dial Transplant. 2007;22(4):1136-43.
Zhao S, Gu X, Groome LJ, Wang Y. Decreasednephrin and GLEPP-1, but increased VEGF, Flt-1,and nitrotyrosine, expressions in kidney tissuesections from women with preeclampsia. Reprod Sci.2009;16(10):970-9.
Garovic VD, Wagner SJ, Turner ST, RosenthalDW, Watson WJ, Brost BC, et al. Urinary podocyteexcretion as a marker for preeclampsia. Am J ObstetGynecol. 2007;196(4):320.e1-7.
Kriz W. The pathogenesis of ‘classic’ focal segmentalglomerulosclerosis-lessons from rat models. NephrolDial Transplant. 2003;18(Suppl 6):vi39-44.
Wang IK, Muo CH, Chang YC, Liang CC, ChangCT, Lin SY, et al. Association between hypertensivedisorders during pregnancy and end-stage renal disease:a population-based study. CMAJ. 2013;185(3):207-13.
Maharaj AS, Saint-Geniez M, Maldonado AE,D’Amore PA. Vascular endothelial growth factorlocalization in the adult. Am J Pathol. 2006;168(2):639-48.
Nochy D, Heudes D, Glotz D, Lemoine R, GentricD, Bruneval P, et al. Preeclampsia associated focaland segmental glomerulosclerosis and glomerularhypertrophy: a morphometric analysis. Clin Nephrol.1994;42(1):9-17.