Preeclampsia and Eclampsia: Nephrologist Perspective

Preeclampsia is a heterogenous, systemic disorder that is caused by maternal and placental factors. Preexisting renal disease and chronic hypertension are significant risk factors for the development of preeclampsia, and the degree of renal insufficiency prior to pregnancy is an important determinant of the risk of maternal complications in pregnancy. While pregnancy itself may accelerate renal decline in some patients, it is not clear whether preeclampsia contributes additional damage. There are currently no clinically used biomarkers that can differentiate preeclampsia from intrinsic renal disease, and an interdisciplinary care approach is the best way to help manage these complex cases. There is evidence that preeclampsia is associated with the future low but increased risk of maternal renal disease. It is still unclear whether it is truly an independent risk factor, but preeclampsia may still identify women early in life who are at future risk of developing renal disease. The optimal long-term follow-up of women with preeclampsia is still not known, but providers should appreciate the significant overlap of renal disease and preeclampsia and have a high index of suspicion in women who do not follow a typical clinical course.