Pulmonary-Renal Syndromes: Goodpasture, ANCA vasculitis, Henoch-Schonlein purpura, cryoglobulinemia Nephrotic Syndromes: minimal change disease, focal segmental glomerulosclerosis, membranous glomerulonephritis, diabetes, amyloidosis, others
Basement Membrane Syndromes: anti-GBM disease, others
Glomerular Vascular Syndromes: atherosclerosis, chronic hypertension, sickle-cell disease, thrombotic microangiopathies, anti phospholipid antibody syndrome, ANCA vasculitis, others
Infectious Disease-Associated Syndromes: poststreptococcal, infective endocarditis, HIV, HBV, HCV, syphilis, others
ANCA = antineutrophilic cytoplasmic antibodies; anti-GBM = anti-glomerular basement membrane; HBV = hepatitis B virus; HCV = hepatitis C virus; HIV = human immunodeficiency virus; IgA = immunoglobulin A; SLE = systemic lupus erythematosus.
Adapted from Lewis, 2015.
2016). One example is systemic lupus erythematosus with a flare during the second half of pregnancy (Bramham, 2012;
Zhao, 2013). In some of these cases, renal biopsy is sometimes needed to determine etiology and direct management (Lind heimer, 2007a; Ramin, 2006).
Whatever the underlying etiology, acute glomerulonephritis has profound efects on pregnancy outcome. One older study described 395 pregnancies in 238 women with primay glo merulonephritis diagnosed before pregnancy (Pacham, 1989).
merulonephritis, IgA glomerulonephritis, and difuse mesan gial glomerulonephritis. Although most of these women had normal renal function, half developed hypertension, a fourth were delivered preterm, and the perinatal mortality rate after 28 weeks' gestation was 80 per 1000. As expected, the worst peri natal outcomes were in women with impaired renal function, early or severe hypertension, and nephrotic-range proteinuria.
women with IgA nephropathy. From their review of more than 300 such pregnancies, Lindheimer and colleagues (2000) con cluded that pregnancy outcome was related to the degree of renal insuiciency and hypertension. Liu and coworkers (2014) reached similar conclusions.
Heavy proteinuria is the hallmark of the nephrotic syndromes.
ders that cause immunological or toxin-mediated injury with glomerular capillary wall breakdown to allow excessive filtra tion of plasma proteins. In addition to heavy urine protein excretion, the syndrome is characterized by hypoalbuminemia, hypercholesterolemia, and edema. There frequently is hyper tension, and along with albumin nephrotoxicity, renal insuf iciency eventually develops.