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慢性肾衰竭患者伴膜增生性肾小球肾炎和子痫前期相关肾病综合征成功妊娠及分娩。

Successful Pregnancy and Delivery in a Chronic Renal Failure Patient with Membranoproliferative Glomerulonephritis and Preeclampsia-related Nephrotic Syndrome.

机构信息

Department of Nephrology, Juntendo University Faculty of Medicine, Japan.

出版信息

Intern Med. 2024 Jul 15;63(14):2035-2042. doi: 10.2169/internalmedicine.1972-23. Epub 2023 Nov 27.

Abstract

A 37-year-old woman with chronic kidney disease (CKD) stage G4 with membranoproliferative glomerulonephritis was hospitalized for nephrotic syndrome and hypertension due to superimposed preeclampsia at 27 weeks into her third pregnancy. Proteinuria did not worsen significantly after pulse steroid therapy. Delivery was induced at 30 weeks' gestation due to the maternal renal function and fetal growth. No obvious fetal complications other than preterm delivery were observed. In this case, we successfully managed a high-risk patient with membranoproliferative glomerulonephritis complicated by advanced CKD, nephrotic syndrome, and hypertension, which are independent risk factors for pregnancy complications.

摘要

一位 37 岁女性,患有慢性肾脏病(CKD)G4 期合并膜增殖性肾小球肾炎,在第三次妊娠的第 27 周时因并发子痫前期而住院,出现肾病综合征和高血压。脉冲类固醇治疗后蛋白尿没有明显恶化。由于母体肾功能和胎儿生长受限,在 30 周时进行了分娩。除早产外,胎儿无明显并发症。在这种情况下,我们成功地治疗了一位患有膜增殖性肾小球肾炎合并晚期 CKD、肾病综合征和高血压的高危患者,这些都是妊娠并发症的独立危险因素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/59f6/11309875/49f773acde87/1349-7235-63-2035-g001.jpg

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