NDT Advance Access originally published online on December 8, 2005
Nephrology Dialysis Transplantation 2006 21(2):268-272; doi:10.1093/ndt/gfi329
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© The Author [2005]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Editorial Comment
Pregnancy of a lupus patient—a challenge to the nephrologist
Department of Medicine, Hospital University Kebangsaan Malaysia, Bandar Tun Razak, Kuala Lumpur, Malaysia
Correpondence and offprint requests to: Norella C. T. Kong, Department of Medicine, Hospital University Kebangsaan Malaysia, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia. Email: norella@mail.hukm.ukm.my
Keywords: antiphospholipid syndrome; breast feeding; lupus nephritis; maternal and fetal outcomes; pregnancy; systemic lupus erythematosus
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Introduction |
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Systemic lupus erythematosus (SLE) is an autoimmune disease with a predilection for women in their reproductive years. The influence of sex hormones on immunity is only beginning to be unravelled, is fascinating and may explain some of the contradictory reports of the effects of pregnancy on SLE and vice versa [1]. Clinical renal involvement occurs in up to 60–80% of lupus patients at some time point in their disease course. In the pre-steroid era, patients with severe lupus nephritis (LN) rarely survived beyond 2 years. With improved therapy of SLE/LN, survival and quality of life for lupus patients have improved vastly. This holds true even for the Asian region [2,3]. Thus, pregnancy and its outcome are a major concern for most SLE/LN patients and their doctors. Indeed, early reports of pregnancy outcome were quite dismal and underscored active disease at conception, hypertension, proteinuria, moderate
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Fertility in SLE |
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Effect of pregnancy on SLE/LN |
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Effect of SLE/LN on pregnancy—obstetric and fetal outcome |
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Lupus nephritis
Pre-eclampsia vs active lupus nephritis
Other renal risk factors
Antiphospholipid syndrome
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Neonatal lupus |
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Medications in pregnancy and the puerperium |
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Conclusions |
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