Updates in diagnosis and management of preeclampsia in women with ckd

Kate Wiles*, Lucy C. Chappell, Liz Lightstone, Kate Bramham

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

28 Citations (Scopus)

Abstract

It is estimated that women with CKD are ten times more likely to develop preeclampsia than women without CKD, with preeclampsia affecting up to 40% of pregnancies in women with CKD. However, the shared phenotype of hypertension, proteinuria, and impaired excretory kidney function complicates the diagnosis of superimposed preeclampsia in women with CKD who have hypertension and/or proteinuria that predates pregnancy. This article outlines the diagnoses of preeclampsia and superimposed preeclampsia. It discusses the pathogenesis of preeclampsia, including abnormal placentation and angiogenic dysfunction. The clinical use of angiogenic markers as diagnostic adjuncts for women with suspected preeclampsia is described, and the limited data on the use of these markers in women with CKD are presented. The role of kidney biopsy in pregnancy is examined. The management of preeclampsia is outlined, including important advances and controversies in aspirin prophylaxis, BP treatment targets, and the timing of delivery.

Original languageEnglish
Pages (from-to)1371-1380
Number of pages10
JournalClinical Journal Of The American Society Of Nephrology
Volume15
Issue number9
DOIs
Publication statusPublished - 7 Sept 2020

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