Abstract: TH-PO149

Utility of Renal Biopsy for Proteinuria in Pregnancy

Session Information

Category: Glomerular

  • 1005 Clinical Glomerular Disorders

Authors

  • Kawashima, Eri, Showa University Fujigaoka Hospital, Yokohama, Japan
  • Inoue, Yoshihiko, Showa University Fujigaoka Hospital, Yokohama, Japan
  • Inui, Kiyoko, Showa University Fujigaoka Hospital, Yokohama, Japan
  • Koiwa, Fumihiko, Showa University Fujigaoka Hospital, Yokohama, Japan
  • Yoshimura, Ashio, Showa University Fujigaoka Hospital, Yokohama, Japan
Background

We are often referred patients who have proteinuria in pregnancy. The patients present various clinical conditions; superimposed preeclampsia, normotensive nephrotic syndrome, complicating hematuria. These clinical conditions sometimes become the risk of pregnancy termination. The patients with proteinuria in pregnancy had renal biopsies, and were discussed utility of the biopsies based on histopathological findings and clinical courses.

Methods

17 patients who had proteinuria in pregnancy had postpartum needle biopsies of their kidneys. Then we analyzed clinical findings to need aggressive treatments, based on histopathological diagnosis and onset of proteinuria.

Results

Before 20 weeks’ gestation, the timing of onset of proteinuria, nine of 11 patients were diagnosed kidney diseases to need treatments. Histopathological diagnoses were IgA nephropathy (n = 6), focal segmental glomerular sclerosis (n = 2), mesangial proliferative nephritis (n = 1). Other 2 patients were thin basement membrane disease and minor abnormality. After 20 weeks’ gestation, two of 6 patients were diagnosed kidney diseases to need treatments, there were IgA nephropathy (n = 1), membranous nephropathy (n = 1). Other 4 patients were histopathological findings of pregnancy induced hypertension (PIH). Compared histopathological PIH with non-PIH about clinical characters, gestational age (PIH; 28.7 ± 2.87, non-PIH; 30.7 ± 4.11 y.o., p = 0.32), maximum proteinuria (9.9 ± 3.03, 1.8 ± 2.71 g/day, p = 0.006), continuous hematuria (p = 0.00002), serum creatinine (0.75 ± 0.21, 0.68 ± 0.23 mg/dl, p = 0.59), eGFR (80.5 ± 26.8, 94.3 ± 43.0 ml/min/1.73m2, p = 0.46), systolic blood pressure (156 ± 8.0, 141 ± 17.7 mmHg, p = 0.03). Significant clinical character of non-PIH was continuous hematuria.

Conclusion

The patients who have proteinuria in pregnancy with continuous hematuria were suspected kidney disease to need aggressive treatments, and renal biopsies were utility as early diagnoses and treatments.