DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193574

A case report on IgA nephropathy in pregnancy

Nupur Anand, A. V. Gokhale, Shonali Agarwal

Abstract


IgA Nephropathy is a primary glomerular disease leading cause of primary glomerulonephritis and one of the important  leading cause of secondary hypertension. Pregnancy causes complex pathological changes in patients with IgA nephropathy affecting the renal function leading to secondary hypertension which in turn affects the prognosis of these patients. The association between chronic kidney disease and increased risk of adverse maternal and fetal outcomes which includes pre-eclampsia, accelerated decline in renal function, intrauterine growth retardation, preterm delivery and fetal death, is well recognised. Management of patients with IgA Nephropathy in pregnancy is challenging and thus authors are discussing here a case with successful outcome. Our patient was a known case of IgA Nephropathy and landed up with complications during pregnancy which was manged successfully.

 


Keywords


Chronic kidney disease, Hypertension, IgA Nephropathy, Preclampsia, Pregnancy, Preterm Labour

Full Text:

PDF

References


Fitzpatrick A, Mohammadi F, Jesudason S. Managing pregnancy in chronic kidney disease: improving outcomes for mother and baby. Int J Womens Health. 2016;8:273-85.

McGrogan A, Franssen CFM, de Vries CS. The incidence of primary glomerulonephritis worldwide: a systematic review of the literature. Nephrol Dial Transplant. 2011;26(2):414-30.

Nevis IF, Reitsma A, Dominic A, McDonald S, Thabane L, Akl EA et al. Pregnancy Outcomes in Women with Chronic Kidney Disease: A Systematic Review. Clin J Am Soc Nephrol. 2011;6(11):2587-98.

Blom K, Odutayo A, Bramham K, Hladunewich MA. Pregnancy and glomerular disease: A systematic review of the literature with management guidelines. Clin J Am Soc Nephrol. 2017;12(11):1862-72.

Goto M, Wakai K, Kawamura T, Ando M, Endoh M, Tomino Y. A scoring system to predict renal outcome in IgA nephropathy: a nationwide 10-year prospective cohort study. Nephrol Dial Transplant. 2009;24(10):3068-74.

Riispere Ž, Laurinavičius A, Kuudeberg A, Seppet E, Sepp K, Ilmoja M et al. IgA nephropathy clinicopathologic study following the Oxford classification: Progression peculiarities and gender-related differences. Medicina (B Aires). 2016;52(6):340-8.

Liu Y, Ma X, Zheng J, Liu X, Yan T. A Systematic Review and Meta-Analysis of Kidney and Pregnancy Outcomes in IgA Nephropathy. Am J Nephrol. 2016;44(3):187-93.

Chronic hypertension - Nice Pathways. https://pathways.nice.org.uk/pathways/hypertension-inpregnancy/preeclampsia#path=view%3A/pathways/hypertension-in-pregnancy/chronic-hypertension.xml&content=view-node%3Anodes-treatment-and-diet. Accessed 23 April 2019.

Abe S. Pregnancy in IgA nephropathy. Kidney international. 1991 Dec 1;40(6):1098-102.