Affiliations 

  • 1 Nephrology Unit, Queen Elizabeth Hospital, Kota Kinabalu, Malaysia
  • 2 Private Practice, Manila, Philippines
  • 3 Royal Perth Hospital, Perth, Australia
  • 4 Department of Nephrology and Hypertension Department, Fundacion Jimenez Diaz Hospital, Madrid, Spain
  • 5 Department of Nephrology, St Luke's University Health Network, PA
  • 6 Institute of Nephrology, Madras Medical College, India
  • 7 Division of Nephrology and Hypertension, University of Mississippi Medical Center, Jackson, MI
  • 8 Section of Nephrology, University of Illinois at Chicago, Chicago, IL
  • 9 Division of Nephrology, University of California Davis School of Medicine, Sacramento, CA
Kidney Med, 2023 Nov;5(11):100724.
PMID: 37915962 DOI: 10.1016/j.xkme.2023.100724

Abstract

Active lupus nephritis (LN) in pregnancy is strongly associated with poor maternal and fetal outcomes and, therefore, has implications on the planning, timing, and management. Prepregnancy evaluation is essential for all LN patients with childbearing potential to ensure pregnancies proceed in a safe and timely manner. Both maternal and fetal risks are communicated to patient during the evaluation. Stratification into different risk profile groups is then made based on disease activity and organ impairment severity. Patients with LN are generally divided into 3 main groups. Patients with LN who become pregnant receive treatments that are nonteratogenic and optimal for fetal and maternal outcomes. Throughout the pregnancy period, these patients are monitored closely under surveillance by a multidisciplinary team of clinicians. The management of patients with LN in pregnancy can be challenging both diagnostically (distinguishing LN from pre-eclampsia and determining the role and timing of kidney biopsy) and therapeutically (LN flares during pregnancy and managing a newly diagnosed LN during pregnancy).

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.