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Journal of Nephrology

, Volume 30, Issue 3, pp 307–317 | Cite as

A best practice position statement on the role of the nephrologist in the prevention and follow-up of preeclampsia: the Italian study group on kidney and pregnancy

  • Giorgina Barbara Piccoli
  • Gianfranca Cabiddu
  • Santina Castellino
  • Giuseppe Gernone
  • Domenico Santoro
  • Gabriella Moroni
  • Donatella Spotti
  • Franca Giacchino
  • Rossella Attini
  • Monica Limardo
  • Stefania Maxia
  • Antioco Fois
  • Linda Gammaro
  • Tullia Todros
  • on behalf of Kidney and Pregnancy Study Group of Italian Society of Nephrology
Position papers and Guidelines
Part of the following topical collections:
  1. Obstetric Nephrology

Abstract

Preeclampsia (PE) is a protean syndrome causing a transitory kidney disease, characterised by hypertension and proteinuria, ultimately reversible after delivery. Its prevalence is variously estimated, from 3 to 5% to 10% if all the related disorders, including also pregnancy-induced hypertension (PIH) and HELLP syndrome (haemolysis, increase in liver enzyme, low platelets) are included. Both nephrologists and obstetricians are involved in the management of the disease, according to different protocols, and the clinical management, as well as the role for each specialty, differs worldwide. The increased awareness of the role of chronic kidney disease in pregnancy, complicating up to 3% of pregnancies, and the knowledge that PE is associated with an increased risk for development of CKD later in life have recently increased the interest and redesigned the role of the nephrologists in this context. However, while the heterogeneous definitions of PE, its recent reclassification, an emerging role for biochemical biomarkers, the growing body of epidemiological data and the new potential therapeutic interventions lead to counsel long-term follow-up, the lack of resources for chronic patients and the increasing costs of care limit the potential for preventive actions, and suggest tailoring specific interventional strategies. The aim of the present position statement of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology is to review the literature and to try to identify theoretical and pragmatic bases for an agreed management of PE in the nephrological setting, with particular attention to the prevention of the syndrome (recurrent PE, presence of baseline CKD) and to the organization of the postpartum follow-up.

Keywords

Chronic kidney disease Evidence based medicine Pregnancy Hypertension Proteinuria Preeclampsia Pre-term delivery 

Notes

Compliance with ethical standards

Ethical approval

This article does not contain any studies with human participants performed by any of the authors.

Conflicts of interest

The authors declare they have no conflict of interest.

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Copyright information

© Italian Society of Nephrology 2017

Authors and Affiliations

  • Giorgina Barbara Piccoli
    • 11
    • 12
  • Gianfranca Cabiddu
    • 1
  • Santina Castellino
    • 2
  • Giuseppe Gernone
    • 3
  • Domenico Santoro
    • 4
  • Gabriella Moroni
    • 5
  • Donatella Spotti
    • 6
  • Franca Giacchino
    • 7
  • Rossella Attini
    • 8
  • Monica Limardo
    • 9
  • Stefania Maxia
    • 1
  • Antioco Fois
    • 1
  • Linda Gammaro
    • 10
  • Tullia Todros
    • 8
  • on behalf of Kidney and Pregnancy Study Group of Italian Society of Nephrology
  1. 1.NephrologyAzienda Ospedaliera BrotzuCagliariItaly
  2. 2.Nephrology and DialysisTaormina HospitalTaorminaItaly
  3. 3.NephrologyS. Maria Degli Angeli HospitalPutignanoItaly
  4. 4.Nephrology and DialysisAOU “G. Martino”MessinaItaly
  5. 5.NephrologyFondazione Ca’ Granda Ospedale MaggioreMilanItaly
  6. 6.Nephrology and DialysisIRCCS Ospedale San RaffaeleMilanoItaly
  7. 7.NephrologyOspedale d’IvreaIvreaItaly
  8. 8.Obstetrics, Department of SurgeryUniversity of TorinoTurinItaly
  9. 9.NephrologyAzienda Ospedaliera della Provincia di LeccoLeccoItaly
  10. 10.Nephrology Ospedale Fracastoro San BonifacioSan BonifacioItaly
  11. 11.Department of Clinical and Biological SciencesUniversity of TorinoTurinItaly
  12. 12.NephrologieCentre Hospitalier Le MansLe MansFrance

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