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GLOMERULONEPHRITIS AND THE NEPHROTIC SYNDROME IN PREGNANCY

Published online by Cambridge University Press:  23 April 2010

MATT HALL
Affiliation:
Department of Nephrology, Leicester General Hospital, Gwendolen Road, Leicester.
NIGEL J BRUNSKILL*
Affiliation:
Department of Nephrology, Leicester General Hospital, Gwendolen Road, Leicester.
*
Professor Nigel J Brunskill, Department of Nephrology, Leicester General Hospital, Gwendolen Rd, Leicester, LE5 4PW E-mail: njb18@le.ac.uk

Extract

Glomerulonephritis (GN) may be manifest clinically in several ways. It may be asymptomatic and associated with only minor urinary dipstick abnormalities, GN may present with one of the classic renal nephritic or nephrotic syndromes, or may be associated with progressive chronic kidney disease with hypertension and the gradual development of uraemia, or it may present with fulminating life threatening illness with severe acute kidney injury. The development of GN may indicate a primary renal limited disease, or may be secondary in association with systemic diseases such as systemic lupus erythematosus (SLE), myeloma, infections or diabetes. Although immunological abnormalities underlie the development of many forms of GN, precise pathogenic mechanisms remain unclear and diagnostic labels may simply reflect a description of the glomerular histological changes observed (Table 1).

Type
Research Article
Copyright
Copyright © Cambridge University Press 2010

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References

REFERENCES

1Wirta, O, Mustonen, J, Helin, H, Pasternack, A. Incidence of biopsy-proven glomerulonephritis. Nephrol Dial Transplant 2008; 23: 193200.CrossRefGoogle ScholarPubMed
2Briganti, EM, Dowling, J, Finlay, M, Hill, PA, Jones, CL, Kincaid-Smith, PS, et al. The incidence of biopsy-proven glomerulonephritis in Australia. Nephrol Dial Transplant 2001; 16: 1364–367.CrossRefGoogle ScholarPubMed
3Stratta, P, Segoloni, GP, Canavese, C, Sandri, L, Mazzucco, G, Roccatello, D, et al. Incidence of biopsy-proven primary glomerulonephritis in an Italian province. Am J Kidney Dis 1996 May; 27: 631–39.CrossRefGoogle Scholar
4Heaf, J, Lokkegaard, H, Larsen, S. The epidemiology and prognosis of glomerulonephritis in Denmark 1985–1997. Nephrol Dial Transplant 1999; 14: 1889–897.CrossRefGoogle ScholarPubMed
5Farrington, K, Udayaraj, U, Gilg, J, Feehally, J. UK Renal Registry 11th Annual Report (December 2008): Chapter 3 ESRD incident rates in 2007 in the UK: national and centre-specific analyses. Nephron Clin Pract 2009; 111 Suppl 1: c1341.CrossRefGoogle Scholar
6Levy, M, Berger, J. Worldwide perspective of IgA nephropathy. Am J Kidney Dis 1988 Nov; 12: 340–47.CrossRefGoogle ScholarPubMed
7Feehally, J. IgA Nephropathy andd Henoch-Schonlein Nephritis. In: Johnson, R, Feehally, J, (eds) Comprehensive Clinical Nephrology. Second ed. London: Mosby; 2003. p. 319–30.Google Scholar
8Hall, M, Brunskill, N. Renal disease and Pregnancy. Obstetrics, Gynaecology, and Reproductive Medicine 2010; doi:10.1016/j.ogrm.2010.02.006.CrossRefGoogle Scholar
9McCartney, CP. Pathological Anatomy of Acute Hypertension of Pregnancy. Circulation 1964; 30: Suppl 2: 3742.CrossRefGoogle ScholarPubMed
10Schewitz, LJ, Friedman, IA, Pollak, VE. Bleeding after renal biopsy in pregnancy. Obstet Gynecol 1965; 26: 295304.Google ScholarPubMed
11Lindheimer, MD, Spargo, BH, Katz, AI. Renal biopsy in pregnancy-induced hypertension. J Reprod Med 1975; 15: 189–94.Google ScholarPubMed
12Packham, D, Fairley, KF. Renal biopsy: indications and complications in pregnancy. Br J Obstet Gynaecol 1987; 94: 935–39.CrossRefGoogle ScholarPubMed
13Day, C, Hewins, P, Hildebrand, S, Sheikh, L, Taylor, G, Kilby, M, et al. The role of renal biopsy in women with kidney disease identified in pregnancy. Nephrol Dial Transplant 2008; 23: 201206.CrossRefGoogle ScholarPubMed
14Strevens, H, Wide-Swensson, D, Hansen, A, Horn, T, Ingemarsson, I, Larsen, S, et al. Glomerular endotheliosis in normal pregnancy and pre-eclampsia. BJOG 2003; 110: 831–36.Google ScholarPubMed
15Sandhu, KS, LaCombe, JA, Fleischmann, N, Greston, WM, Lazarou, G, Mikhail, MS. Gross and microscopic hematuria: guidelines for obstetricians and gynecologists. Obstet Gynecol Surv 2009; 64: 3949.CrossRefGoogle ScholarPubMed
16Szeto, CC, To, KF, Lai, FM, Chow, KM, Tam, WH, Chung, KY, et al. Prevalence and implications of isolated microscopic hematuria in asymptomatic Chinese pregnant women. Nephron Clin Pract 2007; 105: c14752.CrossRefGoogle ScholarPubMed
17Brown, MA, Holt, JL, Mangos, GJ, Murray, N, Curtis, J, Homer, C. Microscopic hematuria in pregnancy: relevance to pregnancy outcome. Am J Kidney Dis 2005; 45: 667–73.CrossRefGoogle ScholarPubMed
18Lazor, R, Bigay-Game, L, Cottin, V, Cadranel, J, Decaux, O, Fellrath, JM, et al. Alveolar hemorrhage in anti-basement membrane antibody disease: a series of 28 cases. Medicine (Baltimore) 2007; 86: 181–93.CrossRefGoogle ScholarPubMed
19Lindic, J, Vizjak, A, Ferluga, D, Kovac, D, Ales, A, Kveder, R, et al. Clinical outcome of patients with coexistent antineutrophil cytoplasmic antibodies and antibodies against glomerular basement membrane. Ther Apher Dial 2009; 13: 278–81.CrossRefGoogle ScholarPubMed
20Jayne, DR, Gaskin, G, Rasmussen, N, Abramowicz, D, Ferrario, F, Guillevin, L, et al. Randomized trial of plasma exchange or high-dosage methylprednisolone as adjunctive therapy for severe renal vasculitis. J Am Soc Nephrol 2007; 18: 2180–188.CrossRefGoogle ScholarPubMed
21Jayne, D, Rasmussen, N, Andrassy, K, Bacon, P, Tervaert, JW, Dadoniene, J, et al. A randomized trial of maintenance therapy for vasculitis associated with antineutrophil cytoplasmic autoantibodies. N Engl J Med 2003; 349: 3644.CrossRefGoogle ScholarPubMed
22Hatfield, T, Steiger, R, Wing, DA. Goodpasture's disease in pregnancy: case report and review of the literature. Am J Perinatol 2007; 24: 619–21.CrossRefGoogle ScholarPubMed
23Seo, P. Pregnancy and vasculitis. Rheum Dis Clin North Am 2007; 33: 299317.CrossRefGoogle ScholarPubMed
24Silva, F, Specks, U, Sethi, S, Irazabal, MV, Fervenza, FC. Successful pregnancy and delivery of a healthy newborn despite transplacental transfer of antimyeloperoxidase antibodies from a mother with microscopic polyangiitis. Am J Kidney Dis 2009; 54: 542–45.CrossRefGoogle ScholarPubMed
25Ramsey-Goldman, R. The effect of pregnancy on the vasculitides. Scand J Rheumatol Suppl 1998; 107: 116–17.CrossRefGoogle ScholarPubMed
26Ishii, K, Kobayashi, M, Koyama, A, Narita, M. Pregnancy associated RPGN (rapidly progressive glomerulonephritis) with repeated attacks of purpura and arthralgia. Nippon Jinzo Gakkai Shi 1989; 31: 693–97.Google ScholarPubMed
27Komatsuda, A, Wakui, H, Yasuda, T, Imai, H, Miura, AB, Tsuda, A, et al. Successful delivery in a pregnant women with crescentic IgA nephropathy. Intern Med 1994; 33: 723–26.CrossRefGoogle Scholar
28Al-Harbi, A, Malik, GH, Al-Mohaya, SA, Akhtar, M. Anti-glomerular Basement Membrane Antibody Disease Presenting as Acute Renal Failure During Pregnancy. Saudi J Kidney Dis Transpl 2003; 14: 516–21.Google ScholarPubMed
29Amir, AR, Sheikh, SS. ANCA-associated crescentic IgA glomerulonephritis in pregnancy. J Nephrol 2002; 15: 716–19.Google ScholarPubMed
30Vasiliou, DM, Maxwell, C, Shah, P, Sermer, M. Goodpasture syndrome in a pregnant woman. Obstet Gynecol 2005; 106: 1196–199.CrossRefGoogle ScholarPubMed
31Adam, FU, Torun, D, Bolat, F, Zumrutdal, A, Sezer, S, Ozdemir, FN. Acute renal failure due to mesangial proliferative glomerulonephritis in a pregnant woman with primary Sjogren's syndrome. Clin Rheumatol 2006; 25: 7579.CrossRefGoogle Scholar
32Barraclough, K, Leone, E, Chiu, A. Renal replacement therapy for acute kidney injury in pregnancy. Nephrol Dial Transplant 2007; 22: 2395–397.CrossRefGoogle ScholarPubMed
33Kart Koseoglu, H, Yucel, AE, Kunefeci, G, Ozdemir, FN, Duran, H. Cyclophosphamide therapy in a serious case of lupus nephritis during pregnancy. Lupus 2001; 10: 818–20.Google Scholar
34Higby, K, Suiter, CR, Phelps, JY. Normal values of urinary albumin and total protein excretion during pregnancy. Am J Obstet Gynecol 1994; 171: 984–89.CrossRefGoogle ScholarPubMed
35Basgul, A, Kavak, ZN, Sezen, D, Basgul, A, Gokaslan, H, Cakalagaoglu, F. A rare case of early onset nephrotic syndrome in pregnancy. Clin Exp Obstet Gynecol 2006; 33: 127–28.Google ScholarPubMed
36Fisher, KA, Ahuja, S, Luger, A, Spargo, BH, Lindheimer, MD. Nephrotic proteinuria with pre-eclampsia. Am J Obstet Gynecol 1977; 129: 643–46.CrossRefGoogle ScholarPubMed
37First, MR, Ooi, BS, Jao, W, Pollak, VE. Pre-eclampsia with the nephrotic syndrome. Kidney Int 1978; 13: 166–77.CrossRefGoogle ScholarPubMed
38Imasawa, T, Nishiwaki, T, Nishimura, M, Shikama, N, Matsumura, R, Nagai, M, et al. A case of “pure” preeclampsia with nephrotic syndrome before 15 weeks of gestation in a patient whose renal biopsy showed glomerular capillary endotheliosis. Am J Kidney Dis 2006; 48: 495501.CrossRefGoogle Scholar
39Brown, MA, Lindheimer, MD, de Swiet, M, Van Assche, A, Moutquin, JM. The classification and diagnosis of the hypertensive disorders of pregnancy: statement from the International Society for the Study of Hypertension in Pregnancy (ISSHP). Hypertens Pregnancy 2001; 20: 914.CrossRefGoogle Scholar
40Chan, P, Brown, M, Simpson, JM, Davis, G. Proteinuria in pre-eclampsia: how much matters? BJOG 2005; 112: 280–85.CrossRefGoogle ScholarPubMed
41Vikse, BE, Irgens, LM, Leivestad, T, Skjaerven, R, Iversen, BM. Preeclampsia and the risk of end-stage renal disease. N Engl J Med 2008; 359: 800809.CrossRefGoogle ScholarPubMed
42Klumb, EM, de Andrade, MC, Jesus, NR, Campani, C, Campos, CF, Levy, RA, et al. Primary antiphospholipid nephropathy beginning during pregnancy. Rheumatol Int 2007; 27: 289–93.CrossRefGoogle ScholarPubMed
43Pandya, BK, Gibson, SP, Robertson, IG. Nephrotic syndrome in early pregnancy–is renal biopsy always necessary? Nephrol.Dial.Transplant. 2002 Apr; 17: 672674.CrossRefGoogle ScholarPubMed
44Weinstock, RS, Kopecky, RT, Jones, DB, Sunderji, S. Rapid development of nephrotic syndrome, hypertension, and hemolytic anemia early in pregnancy in patients with IDDM. Diabetes Care 1988; 11: 416–21.CrossRefGoogle ScholarPubMed
45McLigeyo, SO, Otieno, LS, Kinuthia, DM, Mwongera, FK, Wairagu, SG. Outcome of pregnancy in nephrotic syndrome: a report on five cases. East Afr Med J 1991; 68: 477–83.Google ScholarPubMed
46Yao, T, Yao, H, Wang, H. Diagnosis and treatment of nephrotic syndrome during pregnancy. Chin Med J 1996; 109: 471–73.Google ScholarPubMed
47Hall, M, Lightstone, L, Lipkin, G, Day, C, Carr, S, Brunskill, N. Nephrotic Range Proteinuria in Pregnancy: Fetal Outcomes. 2009; Available at: http://www.abstracts2view.com/asn/view.php?nu=ASN09L1_497a. Accessed February 1st, 2010.Google Scholar
48Kayali, F, Najjar, R, Aswad, F, Matta, F, Stein, PD. Venous thromboembolism in patients hospitalized with nephrotic syndrome. Am J Med 2008; 121: 226–30.CrossRefGoogle ScholarPubMed
49Lindqvist, PG, Kublikas, M, Dahlback, B. Individual risk assessment of thrombosis in pregnancy. Acta Obstet Gynecol Scand 2002; 81: 412–16.CrossRefGoogle ScholarPubMed
50Heit, JA, Kobbervig, CE, James, AH, Petterson, TM, Bailey, KR, Melton, LJ 3rd. Trends in the incidence of venous thromboembolism during pregnancy or postpartum: a 30-year population-based study. Ann Intern Med 2005; 143: 697706.CrossRefGoogle ScholarPubMed
51Brown, M. CKD in pregnancy: Patterns of care and general principles of management. In: Davison, JM, Nelson-Piercy, C, Kehoe, S, Baker, P, editors. Renal disease in pregnancy 1st ed.London: RCOG; 2008; 3144.CrossRefGoogle Scholar
52Levey, AS, Coresh, J, Greene, T, Marsh, J, Stevens, LA, Kusek, JW, et al. Expressing the modification of diet in renal disease study equation for estimating glomerular filtration rate with standardized serum creatinine values. Clin Chem 2007; 53: 766772.CrossRefGoogle ScholarPubMed
53Smith, MC, Moran, P, Ward, MK, Davison, JM. Assessment of glomerular filtration rate during pregnancy using the MDRD formula. BJOG 2008; 115: 109112.CrossRefGoogle ScholarPubMed
54Imbasciati, E, Gregorini, G, Cabiddu, G, Gammaro, L, Ambroso, G, Del Giudice, A, et al. Pregnancy in CKD stages 3 to 5: fetal and maternal outcomes. Am J Kidney Dis 2007; 49: 753–62.CrossRefGoogle ScholarPubMed
55Maynard, SE, Thadhani, R. Pregnancy and the kidney. J Am Soc Nephrol 2009; 20: 1422.CrossRefGoogle ScholarPubMed
56Vidaeff, AC, Yeomans, ER, Ramin, SM. Pregnancy in women with renal disease. Part I: general principles. Am J Perinatol 2008; 25: 385–97.CrossRefGoogle ScholarPubMed
57Williams, D, Davison, J. Chronic kidney disease in pregnancy. Br Med J 2008 336: 211–15.CrossRefGoogle ScholarPubMed
58Nayak, SG, Satish, R, Kedley, P, Deshpande, R, Gokulnath, Garg I. Acute renal failure during pregnancy–an unusual cause. Nephrol Dial Transplant 2007; 22: 264–65.CrossRefGoogle ScholarPubMed
59Singson, E, Fisher, KF, Lindheimer, MD. Acute poststreptococcal glomerulonephritis in pregnancy: case report with an 18-year follow-up. Am J Obstet Gynecol 1980; 137: 857–58.CrossRefGoogle ScholarPubMed
60Fervenza, F, Green, A, Lafayette, RA. Acute renal failure due to postinfectious glomerulonephritis during pregnancy. Am J Kidney Dis 1997; 29: 273–76.CrossRefGoogle ScholarPubMed
61Barratt, J, Feehally, J. Treatment of IgA nephropathy. Kidney Int 2006; 69: 1934–938.CrossRefGoogle ScholarPubMed
62Kincaid-Smith, PS, Whitworth, JA, Fairley, KF. Mesangial IgA nephropathy in pregnancy. Clin Exp Hypertens 1980; 2: 821–38.CrossRefGoogle ScholarPubMed
63Kincaid-Smith, P, Fairley, KF. Renal disease in pregnancy. Three controversial areas: mesangial IgA nephropathy, focal glomerular sclerosis (focal and segmental hyalinosis and sclerosis), and reflux nephropathy. Am J Kidney Dis 1987; 9: 328–33.CrossRefGoogle ScholarPubMed
64Packham, DK, North, RA, Fairley, KF, Whitworth, JA, Lloren, PR, Lee, E, et al. Pregnancy in women with diffuse mesangial proliferative glomerulonephritis. Clin Nephrol 1988; 29: 193–98.Google ScholarPubMed
65Jungers, P, Forget, D, Houillier, P, Henry-Amar, M, Grunfeld, JP. Pregnancy in IgA nephropathy, reflux nephropathy, and focal glomerular sclerosis. Am J Kidney Dis 1987; 9: 334338.CrossRefGoogle ScholarPubMed
66Imbasciati, E, Ponticelli, C. Pregnancy and renal disease: predictors for fetal and maternal outcome. Am.J.Nephrol 1991; 11: 353–62.CrossRefGoogle ScholarPubMed
67Matsuyama, T, Sugihara, Y, Iwasaki, K, Fujii, A. Clinical studies of IgA nephropathy during pregnancy. Nippon Sanka Fujinka Gakkai Zasshi 1989; 41: 1517–522.Google ScholarPubMed
68Packham, D, Whitworth, JA, Fairley, KF, Kincaid-Smith, P. Histological features of IgA glomerulonephritis as predictors of pregnancy outcome. Clin Nephrol 1988; 30: 2226.Google ScholarPubMed
69Abe, S. Pregnancy in IgA nephropathy. Kidney Int 1991; 40: 1098–102.CrossRefGoogle ScholarPubMed
70Koido, S, Makino, H, Iwazaki, K, Makino, T. IgA nephropathy and pregnancy. Tokai J Exp Clin Med 1998; 23: 3137.Google ScholarPubMed
71Jungers, P, Houillier, P, Forget, D, Henry-Amar, M. Specific controversies concerning the natural history of renal disease in pregnancy. Am J Kidney Dis 1991; 17: 116–22.CrossRefGoogle ScholarPubMed
72Takeda, S, Kida, H, Takasawa, K, Ikeda, K, Katagiri, M, Yoshimura, M, et al. Influence of pregnancy on IgA nephropathy. Nippon Jinzo Gakkai Shi 1989; 31: 6775.Google ScholarPubMed
73Nagai, Y, Waschizawa, Y, Suzuki, T, Fushimi, T, Hirata, K, Kawamura, S, et al. Influence of gestation on renal function in gravida with IgA nephropathy. Nippon Jinzo Gakkai Shi 1989; 31: 635641.Google ScholarPubMed
74Abe, S. The influence of pregnancy on the long-term renal prognosis of IgA nephropathy. Clin Nephrol 1994; 41: 6164.Google ScholarPubMed
75Nishimoto, K, Shiiki, H, Nishino, T, Kimura, T, Sasaki, Y, Yamasaki, M, et al. Glomerular hypertrophy in preeclamptic patients with focal segmental glomerulosclerosis. A morphometric analysis. Clin Nephrol 1999; 51: 209–19.Google ScholarPubMed
76Lee, HS, Kim, TS. A morphometric study of preeclamptic nephropathy with focal segmental glomerulosclerosis. Clin Nephrol 1995; 44: 1421.Google ScholarPubMed
77Nochy, D, Heudes, D, Glotz, D, Lemoine, R, Gentric, D, Bruneval, P, et al. Preeclampsia associated focal and segmental glomerulosclerosis and glomerular hypertrophy: a morphometric analysis. Clin Nephrol 1994; 42: 917.Google ScholarPubMed
78Grcevska, L, Polenakovic, M. Focal glomerular sclerosis (FGS)-like lesions are not rare in preeclampsia. Clin Nephrol 1992; 38: 233–34.Google Scholar
79Nagai, Y, Arai, H, Washizawa, Y, Ger, Y, Tanaka, M, Maeda, M, et al. FSGS-like lesions in pre-eclampsia. Clin Nephrol 1991; 36: 134–40.Google ScholarPubMed
80Shiiki, H, Dohi, K, Hanatani, M, Fujii, Y, Sanai, H, Ichijo, M, et al. Focal and segmental glomerulosclerosis in preeclamptic patients with nephrotic syndrome. Am J Nephrol 1990; 10: 205–12.CrossRefGoogle ScholarPubMed
81Davison, JM, Bailey, DJ. Pregnancy following renal transplantation. J Obstet Gynaecol Res 2003; 29: 227–33.CrossRefGoogle ScholarPubMed
82Kirshon, B, Wasserstrum, N, Willis, R, Herman, GE, McCabe, ER. Teratogenic effects of first-trimester cyclophosphamide therapy. Obstet Gynecol 1988; 72: 462–64.Google ScholarPubMed
83Wada, T, Nagaoka, Y, Matsumoto, H, Okada, T, Han, M, Yoshino, M, et al. A pregnant woman with nephrotic syndrome and focal segmental lesions. Nippon Jinzo Gakkai Shi 2006; 48: 680–84.Google ScholarPubMed
84Alexopoulos, E, Bili, H, Tampakoudis, P, Economidou, D, Sakellariou, G, Mantalenakis, S, et al. Outcome of pregnancy in women with glomerular diseases. Ren Fail 1996 Jan; 18: 121–29.CrossRefGoogle ScholarPubMed
85Brunskill, N. Renal biopsy in pregnancy. In: Davison, JM, Nelson-Piercy, C, Kehoe, S, Baker, P, editors. Renal disease in pregnancy. First ed.London: RCOG; 2008. p. 201206.CrossRefGoogle Scholar
86Park-Wyllie, L, Mazzotta, P, Pastuszak, A, Moretti, ME, Beique, L, Hunnisett, L, et al. Birth defects after maternal exposure to corticosteroids: prospective cohort study and meta-analysis of epidemiological studies. Teratology 2000; 62: 385–92.3.0.CO;2-Z>CrossRefGoogle ScholarPubMed
87McKay, DB, Josephson, MA. Pregnancy in recipients of solid organs–effects on mother and child. N Engl J Med 2006; 354: 1281–293.CrossRefGoogle ScholarPubMed
88Seckl, JR, Holmes, MC. Mechanisms of disease: glucocorticoids, their placental metabolism and fetal ‘programming’ of adult pathophysiology. Nat Clin Pract Endocrinol Metab 2007; 3: 479–88.CrossRefGoogle ScholarPubMed
89Armenti, VT, Moritz, MJ, Cardonick, EH, Davison, JM. Immunosuppression in pregnancy: choices for infant and maternal health. Drugs 2002; 62: 2361–375.CrossRefGoogle ScholarPubMed
90Le Thi Huong, D, Wechsler, B, Piette, JC. Effect of pregnancy, menopause and hormone substitution therapy on disseminated systemic lupus erythematosus. Presse Med 2000; 29: 5560.Google Scholar
91Moroni, G, Quaglini, S, Banfi, G, Caloni, M, Finazzi, S, Ambroso, G, et al. Pregnancy in lupus nephritis. Am J Kidney Dis 2002; 40: 713–20.CrossRefGoogle ScholarPubMed
92Beck, LH Jr, Bonegio, RG, Lambeau, G, Beck, DM, Powell, DW, Cummins, TD, et al. M-type phospholipase A2 receptor as target antigen in idiopathic membranous nephropathy. N Engl J Med 2009; 361: 1121.CrossRefGoogle ScholarPubMed
93Segarra, A, Praga, M, Ramos, N, Polanco, N, Cargol, I, Gutierrez-Solis, E, et al. Successful treatment of membranous glomerulonephritis with rituximab in calcineurin inhibitor-dependent patients. Clin J Am Soc Nephrol 2009; 4: 10831088.CrossRefGoogle ScholarPubMed
94Rees, A, Kain, R. Nephrotic syndrome: a watershed in the understanding of membranous nephropathy. Nat Rev Nephrol 2009; 5: 617–18.CrossRefGoogle ScholarPubMed
95Luno, J, Barrio, V, Goicoechea, MA, Gonzalez, C, de Vinuesa, SG, Gomez, F, et al. Effects of dual blockade of the renin-angiotensin system in primary proteinuric nephropathies. Kidney Int Suppl 2002; 82: S4752.CrossRefGoogle Scholar
96Cooper, WO, Hernandez-Diaz, S, Arbogast, PG, Dudley, JA, Dyer, S, Gideon, PS, et al. Major congenital malformations after first-trimester exposure to ACE inhibitors. N Engl J Med 2006; 354: 2443–451.CrossRefGoogle ScholarPubMed
97Ponticelli, C, Passerini, P, Salvadori, M, Manno, C, Viola, BF, Pasquali, S, et al. A randomized pilot trial comparing methylprednisolone plus a cytotoxic agent versus synthetic adrenocorticotropic hormone in idiopathic membranous nephropathy. Am J Kidney Dis 2006; 47: 233–40.CrossRefGoogle Scholar
98Abe, S, Amagasaki, Y, Konishi, K, Kato, E, Sakaguchi, H, Iyori, S. The influence of antecedent renal disease on pregnancy. Am J Obstet Gynecol 1985; 153: 508–14.CrossRefGoogle ScholarPubMed
99Surian, M, Imbasciati, E, Cosci, P, Banfi, G, Barbiano di Belgiojoso, G, Brancaccio, D, et al. Glomerular disease and pregnancy. A study of 123 pregnancies in patients with primary and secondary glomerular diseases. Nephron 1984; 36: 101105.CrossRefGoogle ScholarPubMed
100Packham, DK, North, RA, Fairley, KF, Whitworth, JA, Kincaid-Smith, P. Membranous glomerulonephritis and pregnancy. Clin Nephrol 1987; 28: 5664.Google ScholarPubMed
101Malik, GH, Al-Harbi, AS, Al-Mohaya, S, Al-Wakeel, J, Al-Hozaim, W, Kechrid, M, et al. Repeated pregnancies in patients with primary membranous glomerulonephritis. Nephron 2002; 91: 2124.CrossRefGoogle ScholarPubMed
102Katzir, Z, Rotmensch, S, Boaz, M, Biro, A, Michlin, A, Smetana, S. Pregnancy in membranous glomerulonephritis–course, treatment and outcome. Clin Nephrol 2004; 61: 5962.CrossRefGoogle ScholarPubMed
103Sebestyen, A, Varbiro, S, Sara, L, Deak, G, Kerkovits, L, Szabo, I, et al. Successful management of pregnancy with nephrotic syndrome due to preexisting membranous glomerulonephritis: a case report. Fetal Diagn Ther 2008; 24: 186–89.CrossRefGoogle ScholarPubMed
104Schmitt, H, Bohle, A, Reineke, T, Mayer-Eichberger, D, Vogl, W. Long-term prognosis of membranoproliferative glomerulonephritis type I. Significance of clinical and morphological parameters: an investigation of 220 cases. Nephron 1990; 55: 242–50.CrossRefGoogle ScholarPubMed
105Schena, FP. Primary glomerulonephritides with nephrotic syndrome. Limitations of therapy in adult patients. J Nephrol 1999; 12 Suppl 2: S12530.Google ScholarPubMed
106Inaba, S, Tanizawa, T, Igarashi, T, Higuchi, A, Satou, H, Mase, D, et al. Long-term follow-up of membranoproliferative glomerulonephritis type II and pregnancy: a case report. Clin Nephrol 1989; 32: 1013.Google ScholarPubMed
107Kurdoglu, M, Kurdoglu, Z, Adali, E, Soyoral, Y, Erkoc, R. Successful management of membranoproliferative glomerulonephritis type I in pregnancy. Arch Gynecol Obstet 2009 Apr 9. Epub ahead of print.CrossRefGoogle Scholar
108Malik, GH, Al-Mohaya, S, Shaikh, JF, Al-Wakeel, J, Al-Hozaim, W, Kechrid, M, et al. Repeated pregnancies in patients with non-immunoglobulin a mesangioproliferative glomerulonephritis. Am J Nephrol 2001; 21: 378–82.CrossRefGoogle ScholarPubMed
109Grekas, D, Vasiliou, S, Kalekou, H, Tourkantonis, A. Effect of pregnancy on the natural course of preexistent glomerular disease. Biol Res Pregnancy Perinatol 1985; 6: 184–86.Google ScholarPubMed
110Abe, S. An overview of pregnancy in women with underlying renal disease. Am J Kidney Dis 1991; 17: 112115.CrossRefGoogle ScholarPubMed
111Barcelo, P, Lopez-Lillo, J, Cabero, L, Del Rio, G. Successful pregnancy in primary glomerular disease. Kidney Int 1986; 30: 914–19.CrossRefGoogle ScholarPubMed
112Leichter, HE, Jordan, SC, Cohen, AH, Ettenger, RB, Salusky, IB, Fine, RN. Postpartum renal failure in a patient with membranoproliferative glomerulonephritis type II. Am J Nephrol 1986; 6: 382–85.CrossRefGoogle Scholar
113Morton, MR, Bannister, KM. Renal failure due to mesangiocapillary glomerulonephritis in pregnancy: use of plasma exchange therapy. Clin Nephrol 1993; 40: 7478.Google ScholarPubMed
114Deubner, H, Wagnild, JP, Wener, MH, Alpers, CE. Glomerulonephritis with anti-glomerular basement membrane antibody during pregnancy: potential role of the placenta in amelioration of disease. Am J Kidney Dis 1995; 25: 330–35.CrossRefGoogle ScholarPubMed
115Jennette, JC, Falk, RJ. New insight into the pathogenesis of vasculitis associated with antineutrophil cytoplasmic autoantibodies. Curr Opin Rheumatol 2008; 20: 5560.CrossRefGoogle ScholarPubMed
116Jones, RB, Ferraro, AJ, Chaudhry, AN, Brogan, P, Salama, AD, Smith, KG, et al. A multicenter survey of rituximab therapy for refractory antineutrophil cytoplasmic antibody-associated vasculitis. Arthritis Rheum 2009; 60: 2156–168.CrossRefGoogle ScholarPubMed
117Silva, F, Specks, U, Kalra, S, Hogan, MC, Leung, N, Sethi, S, et al. Mycophenolate Mofetil for Induction and Maintenance of Remission in Microscopic Polyangiitis with Mild to Moderate Renal Involvement–A Prospective, Open-Label Pilot Trial. Clin J Am Soc Nephrol 2010; Jan 21. Epub ahead of print.CrossRefGoogle Scholar
118Bansal, PJ, Tobin, MC. Neonatal microscopic polyangiitis secondary to transfer of maternal myeloperoxidase-antineutrophil cytoplasmic antibody resulting in neonatal pulmonary hemorrhage and renal involvement. Ann Allergy Asthma Immunol 2004; 93: 398401.CrossRefGoogle ScholarPubMed
119Schlieben, DJ, Korbet, SM, Kimura, RE, Schwartz, MM, Lewis, EJ. Pulmonary-renal syndrome in a newborn with placental transmission of ANCAs. Am J Kidney Dis 2005; 45: 758–61.CrossRefGoogle Scholar
120Packham, D. Thin basement membrane nephropathy in pregnancy. Semin Nephrol 2005; 25: 180–83.CrossRefGoogle ScholarPubMed
121Zhang, HW, Ding, J, Wang, F, Yang, HX. Follow-up study on the pregnancy of an X-linked dominant Alport syndrome female. Beijing Da Xue Xue Bao 2007; 39: 351–54.Google ScholarPubMed
122Matsuo, K, Tudor, EL, Baschat, AA. Alport syndrome and pregnancy. ObstetGynecol 2007; 109: 531532.Google Scholar