Complex Management of Nephrotic Syndrome and Kidney Failure during Pregnancy in a Type 1 Diabetes Patient: A Challenging Case - Archive ouverte HAL Access content directly
Journal Articles Journal of Clinical Medicine Year : 2022

Complex Management of Nephrotic Syndrome and Kidney Failure during Pregnancy in a Type 1 Diabetes Patient: A Challenging Case

(1, 2) , (3) , (1) , (4) , (1) , (5) , (1, 6, 7)
1
2
3
4
5
6
7

Abstract

Pregnancy with chronic kidney disease is challenging, and patients with diabetic nephropathy are at particular risk of a rapid kidney function decline during pregnancy. While indications for the management of pregnant patients with initial diabetic nephropathy are widely available in the literature, data on patients with severe nephrotic syndrome and kidney function impairment are lacking, and the decision on whether and when dialysis should be initiated is not univocal. We report a type 1 diabetes patient who started pregnancy with a severe nephrotic syndrome and shifted from CKD stage 3b to stage 5 during pregnancy. The management was complicated by a fetal heart malformation and by poorly controlled diabetes. The evidence for and against starting dialysis was carefully evaluated, and the choice of strict nephrological and obstetrical monitoring, nutritional management, and diuretic treatment made it possible to avoid dialysis in pregnancy, after ruling out pre-eclampsia. This experience enables examination of some open issues and contributes to the discussion of when to start dialysis in pregnancy.
Fichier principal
Vignette du fichier
jcm-11-05725-v2.pdf (1.17 Mo) Télécharger le fichier
Origin : Publisher files allowed on an open archive

Dates and versions

inserm-03881045 , version 1 (01-12-2022)

Identifiers

Cite

Leo Drapeau, Mathilde Beaumier, Julie Esbelin, François Comoz, Lucile Figueres, et al.. Complex Management of Nephrotic Syndrome and Kidney Failure during Pregnancy in a Type 1 Diabetes Patient: A Challenging Case. Journal of Clinical Medicine, 2022, 11 (19), pp.5725. ⟨10.3390/jcm11195725⟩. ⟨inserm-03881045⟩
0 View
0 Download

Altmetric

Share

Gmail Facebook Twitter LinkedIn More