Nephrotic Syndrome

  • Stephanie I. Byerly


Nephrotic syndrome (NS) is a parenchymal glomerulopathy characterized by proteinuria, hypoalbuminemia, hyperlipidemia, and generalized edema. NS can be primary or secondary. Pregnancy may adversely affect the progression of NS leading to worsening or progression to end-stage renal disease (ESRD).

Most women with a diagnosis of NS will proceed to have a successful pregnancy if severe hypertension and renal insufficiency are not present. Antihypertensive agents including nifedipine, labetalol, methyldopa, and hydralazine are acceptable in pregnancy. Anticoagulation may be required in NS in patients with severe hypoalbuminemia.

Regional anesthesia is acceptable in NS patients that are not anticoagulated, but careful attention must be payed to ensure adequate intravascular volume status. Invasive monitoring may be necessary.


Nephrotic Syndrome Anesthesia Pregnancy Regional General Treatment 


  1. 1.
    Fischer MJ, Lehnerz SD, Hebert JR, Parikh CR. Kidney disease is an independent risk factor for adverse fetal and maternal outcomes in pregnancy. Am J Kidney Dis. 2004;43:415–23.CrossRefGoogle Scholar
  2. 2.
    Krane NK. Acute renal failure in pregnancy. Arch Intern Med. 1988;148:2347–57.CrossRefGoogle Scholar
  3. 3.
    Kong NC. Pregnancy of a lupus patient—a challenge to the nephrologist. Nephrol Dial Transplant. 2006;2:268–72.CrossRefGoogle Scholar
  4. 4.
    Osmundson SS, Lafayete RA, Bowen RA, et al. Maternal proteinuria in twin compared with singleton pregnancies. Obstet Gynecol. 2014;124:332.CrossRefGoogle Scholar
  5. 5.
    Zen M, Ghirardello A, Iaccarino L, et al. Hormones, immune response, and pregnancy in healthy women and SLE patients. Swiss Med Wkly. 2010;140:13–4.Google Scholar
  6. 6.
    Stevenson RE, Burton OM, Ferlauto GJ, Taylor HA. Hazards of oral anticoagulation during pregnancy. JAMA. 1980;243(15):1549–51.CrossRefGoogle Scholar
  7. 7.
    Malik GH, Al-Harbi AS, Al-Mohaya S, et al. Repeated pregnancies in patients with primary membranous glomerulonephritis. Nephron. 2002;91:21–4.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain ManagementUniversity of Texas SouthwesternDallasUSA

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