Pregnancy and Nephrotic Syndrome

we should have a well knowing of the relationship between pregnancy and Nephrotic Syndrome.
1. The types of Nephrotic Syndrome in pregnancy
Nephrotic Syndrome in pregnancy can be divided into four types:
· Nephrotic Syndrome associated with pre-eclampsia
It is the most common type of Nephrotic Syndrome in pregnancy.
· Cyclic Nephrotic Syndrome of Pregnancy
Its characteristic is it will attack in the duration of pregnancy, and will remit spontaneously after the pregnancy terminates. However, it will relapse when the women are pregnant once again. This type is rarely seen.
· Chronic Glomerulonephritis accompanied by pregnancy
For women with this type Nephrotic Syndrome, the women must have a medical history of Nephritis, or it is found for the first time during the period of pregnancy.
· Secondary Nephrotic Syndrome
It is caused by pregnancy combined with other reasons. And it can be seen in Lupus Nephritis, Diabetic Nephropathy, Renal Vein Thrombosis and others.
2. The physiological changes of the kidneys in pregnancy
A. The morphological changes of the kidneys
· In the period of pregnancy, the size and the weight of the kidneys will both increase.
· The collecting duct system of the kidneys will have obvious changes.
B. The changes of the renal functions
In the period of pregnancy, the effective renal plasma flow(ERPF) and the glomerular filtration rate(GFR) of the kidneys will increase significantly.
The increase of the GFR will change the normal biochemical values. If the value of serum creatinine, urea nitrogen(BUN) and uric acid(UA) respectively excesses 70.7 µmol/L, 4.64 mmol/L and 268 µmol/L, then it is abnormal.
The increase of the ERPF and GFR will make the glomeruli be in a state of hyperperfusion and hyperfiltration. For pregnant women with kidney disease and Hypertension, such kind physiological change are definite risk factor, which will lead to and accelerate the sclerosis of the glomeruli and the worsening of the kidney function.
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