**Preeclampsia usually begins in the third trimester, but can occur earlier in patients with preexisting renal disease or hypertension; as early as 20 weeks.
** It can also occur postpartum with hypertension, even up to 6 weeks after delivery.
**.It presents with weight gain andedema, particularly of the hands and face, proteinuria and HTN. Nephrotic syndrome is noted. Other lab parameters are elevated uric acid, LDH, liver function tests, and can progress to oliguria. Fatty liver of pregnancy, HELLP syndrome, TMA associated with pregnancy all have to be ruled out.
** The severe HTN can itself lead to TMA like picture causing schistocytes to be noted on smear, down-trending haptoglobin and hemolysis ensues.
**There is a fall in renal blood flow and GFR that can lead to hyperuricemia and hypocalciuria as well as acute renal failure. The acute renal failure is thought to be due to glomerular endotheliosis withswelling of endothelial cells and subendothelial hyaline and fibrin deposition. Acute tubular necrosis and cortical necrosis can also occur.
**Pulmonary edema can occur due to changes in pulmonary capillary permeability.
**Hyperreflexia reflects increased nervous system excitability.When preeclampsia is more severe, it can progress to the HELLP syndrome with hemolysis, elevated liver enzymes,and low platelets.
**Due to decreased placental perfusion, fetal growth restriction and oligohydramnios can occur.
For more information take a look at this review for all.
- ► 2019 (42)
- ► 2018 (57)
- ► 2017 (52)
- ► 2016 (45)
- ► 2015 (63)
- ► 2014 (95)
- ► 2013 (133)
- ► 2012 (201)
- Fascinating Wordle in AJT 2011
- NKF 2011 Live Blogging from Nephrology on Demand
- TOPIC DISCUSSION: Vascular Amyloidosis and the Kidney
- NKF 2011 Live Blogging: Integrating the treatment ...
- TOPIC DISCUSSION: TMA ( AJKD tells the tale of 2 d...
- Nephron Animation website
- CONSULT ROUNDS: Renal Involvement in Bardet-Biedl ...
- USA-Nephronpower Wordle( Nephrology Rules)
- Dichotomous Effects of Rapamycin
- TOPIC DISCUSSION: The impact of stopping inhibitor...
- Health News - Research brings new hope of renal re...
- AJP Podcasts
- IN THE NEWS--> Salt sensitive HTN and temperature?
- TOPIC DISCUSSION: Renal Denervation for Treatment ...
- CONSULT ROUNDS: Pre Eclampsia
- Online CME resource( Nephrology)
- Pediatrics Grand rounds continue
- TOPIC DISCUSSION: Hypophosphatemia in Nocturnal he...
- Journal CLUB: Pediatric Nephrology
- IN THE NEWS--> Statins and the Kidney after surgery
- Arteries and Kidney Transplant
- Pancreas Transplantation in the Treatment of Diabetes
- IN THE NEWS -MDR-1 polymorphisms in steroid resist...
- TOPIC DISCUSSIONS: Glomerular Disease following co...
- May 2011 Hofstra University Kidney Walk
- IN THE NEWS:- RENALASE and CKD
- Transplant Tourism and Malignancy
- IN THE NEWS --->Innovative tools in nephrology su...
- TOPIC DISCUSSION: Rheumatoid Arthritis and the Kidney
- Cystic Diseases of the Kidney: A primer
- CLINICAL CASE 35, ANSWERS AND SUMMARY
- Submit Kidney Week 2011 Abstracts
- IVIG - how does it work from the Immunology blog?
- JOURNAL CLUB: CHOICE STUDY
- IN THE NEWS- ANCA in the Elderly
- Medicine for residents: Calcium gluconate in a dig...
- IN THE NEWS--> Detective Nephron's next venture
- Neutropenia from Tacrolimus
- IN THE NEWS-- Serum Bilirubin and chronic dialysis...
- ▼ April (39)
- ► 2010 (461)