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.
KeywordsNephrotic Syndrome Anesthesia Pregnancy Regional General Treatment
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