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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

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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.

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Authors and Affiliations

  1. Nephrology, Azienda Ospedaliera Brotzu, Cagliari, Italy

    Gianfranca Cabiddu, Stefania Maxia & Antioco Fois

  2. Nephrology and Dialysis, Taormina Hospital, Taormina, Italy

    Santina Castellino

  3. Nephrology, S. Maria Degli Angeli Hospital, Putignano, Italy

    Giuseppe Gernone

  4. Nephrology and Dialysis, AOU “G. Martino”, Messina, Italy

    Domenico Santoro

  5. Nephrology, Fondazione Ca’ Granda Ospedale Maggiore, Milan, Italy

    Gabriella Moroni

  6. Nephrology and Dialysis, IRCCS Ospedale San Raffaele, Milano, Italy

    Donatella Spotti

  7. Nephrology, Ospedale d’Ivrea, Ivrea, Italy

    Franca Giacchino

  8. Obstetrics, Department of Surgery, University of Torino, Turin, Italy

    Rossella Attini & Tullia Todros

  9. Nephrology, Azienda Ospedaliera della Provincia di Lecco, Lecco, Italy

    Monica Limardo

  10. Nephrology Ospedale Fracastoro San Bonifacio, San Bonifacio, Italy

    Linda Gammaro

  11. Department of Clinical and Biological Sciences, University of Torino, Turin, Italy

    Giorgina Barbara Piccoli

  12. Nephrologie, Centre Hospitalier Le Mans, Avenue Roubillard, 72000, Le Mans, France

    Giorgina Barbara Piccoli

Authors
  1. Giorgina Barbara Piccoli
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  2. Gianfranca Cabiddu
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  3. Santina Castellino
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  4. Giuseppe Gernone
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  5. Domenico Santoro
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  6. Gabriella Moroni
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  7. Donatella Spotti
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  8. Franca Giacchino
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  9. Rossella Attini
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  10. Monica Limardo
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  11. Stefania Maxia
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  12. Antioco Fois
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  13. Linda Gammaro
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  14. Tullia Todros
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Consortia

on behalf of Kidney and Pregnancy Study Group of Italian Society of Nephrology

Corresponding author

Correspondence to Giorgina Barbara Piccoli.

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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.

Additional information

This article is part of the topical collection on Obstetric Nephrology.

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Piccoli, G.B., Cabiddu, G., Castellino, S. et al. 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. J Nephrol 30, 307–317 (2017). https://doi.org/10.1007/s40620-017-0390-1

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  • DOI: https://doi.org/10.1007/s40620-017-0390-1

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