子痫前期继发肾病综合征:5年经验观察的表现、管理和临床演变

IF 1.2 Q3 CARDIAC & CARDIOVASCULAR SYSTEMS Hipertension y Riesgo Vascular Pub Date : 2023-01-01 DOI:10.1016/j.hipert.2022.05.008
A.M. Ghelfi , F. Garavelli , B. Meres , F.R. Dipaolo , M.N. Lassus , A.L. Pahud , M. Vazquez , J.G. Kilstein , R.F. Mamprin D’Andrea
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引用次数: 1

摘要

引言肾病综合征(NS)在妊娠期是罕见的。主要原因是严重的先兆子痫(PR)。我们的目的是描述女性PE引起NS的临床表现、分析特征、医疗管理和进展。材料和方法2017年1月至2022年1月进行的一项描述性回顾性研究(5年)。胎龄(GA)≥20周的女性被纳入研究,她们因妊娠期高血压疾病(HDP)而住院,在妊娠前没有肾损伤的证据。结果652例HDP中,检出PE 452例,NS 21例。母亲年龄为25±5.7岁,诊断时GA为33.1±5.1周。所有女性均有面部和外周水肿:5例胸腔积液,3例心包积液,2例肛门积液。他们的p24为6.17±2.34克(3.10-10.8),血清白蛋白为2.5±0.27 g/dL(2.10.2.90),血清胆固醇为281.4±21.7 mg/dL(251-316)。13例出现母体并发症:急性肾损伤、肺水肿、扩张型心肌病、子痫和HELLP综合征。她们产后仍然患有高血压,需要两到三种降压药的联合用药。她们产后都服用了他汀类药物,并服用了血管紧张素转换酶(ACE)抑制剂来控制蛋白尿。没有人出现高钾血症或肌酸酐升高。住院10.4±3.7天。所有肾病范围蛋白尿参数在出院前均逆转。没有死亡记录。结论表现范围从外周水肿到浆液性受累。蛋白尿的严重程度各不相同。ACE抑制剂的使用不会导致高钾血症或肾衰竭。产妇并发症频繁,但没有死亡记录。
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Síndrome nefrótico secundario a preeclampsia: presentación, manejo y evolución clínica observados en 5 años de experiencia

Introduction

Nephrotic syndrome (NS) is rare during pregnancy. The main cause is severe pre-eclampsia (PR). Our aim was to describe the clinical presentation, analytical features, medical management, and progress of women with NS due to PE.

Materials and methods

A descriptive, retrospective study, conducted from 01/01/2017 to 01/01/2022 (5 years). Women with a gestational age (GA) ≥ 20 weeks were included in the study, hospitalised due to hypertensive disorders in pregnancy (HDP), with no evidence of kidney damage prior to gestation.

Results

Of the 652 HDP, 452 PE and 21 NS were identified. Maternal age was 25 ± 5.7 years, GA at diagnosis was 33.1 ± 5.1 weeks. All the women had facial and peripheral oedema: 5 pleural effusion, 3 pericardial effusion, and 2 anasarca. Their p24 was 6.17 ± 2.34 grams (3.10-10.8), serum albumin 2.5 ± 0.27 g/dL (2.10-2.90), and serum cholesterol 281.4 ± 21.7 mg/dL (251-316). Thirteen developed maternal complications: acute kidney damage, pulmonary oedema, dilated cardiomyopathy, eclampsia, and HELLP syndrome. They all remained hypertensive postpartum, and required a combination of two to three antihypertensive drugs. They all received statins postpartum, and angiotensin converting enzyme (ACE) inhibitors to manage proteinuria. None developed hyperkalaemia or creatinine elevation. Hospital stay was 10.4 ± 3.7 days. All nephrotic range proteinuria parameters reversed prior to discharge. No deaths were recorded.

Conclusion

Presentation ranged from peripheral oedema to serous involvement. Severity of proteinuria varied. Use of ACE inhibitors did not precipitate hyperkalaemia or kidney failure. Maternal complications were frequent, but no deaths were recorded.

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来源期刊
Hipertension y Riesgo Vascular
Hipertension y Riesgo Vascular Medicine-Internal Medicine
CiteScore
1.70
自引率
16.70%
发文量
38
审稿时长
39 days
期刊介绍: La mejor publicación para mantenerse al día en los avances de la lucha contra esta patología. Incluye artículos de Investigación, Originales, Revisiones, Casos clínicos, Aplicación práctica y Resúmenes comentados a la bibliografía internacional. Además, es la Publicación Oficial de la Sociedad española de Hipertensión-Liga Española para la Lucha contra la Hipertensión Arterial.
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