EVALUATION OF LUPUS NEPHRITIS DURING PREGNANCY BY RENAL BIOPSY

Patients with lupus nephritis frequently exhibit increasing proteinuri a, hyper-tension and deterioration of renal function due to either act ive lupus nephritis, chronic lupus nephritis and/or superimposed preec lampsia during pregnancy. Percutaneous renal biopsies were therefore p erformed in 3 women with systemic lupus erythematosus during pregnancy and immediately postpartum in a fourth woman to evaluate their renal disease during pregnancy. Mean serum creatinine at renal biopsy was 2. 9 mg/dl, with a mean creatinine clearance of 66 ml/min and protein exc retion of 5.3 g/day. All patients had grade IV lupus nephritis and rec eived pulse methylprednisolone immediately; 3 received cyclophosphamid e. All 3 patients with crescent formation developed endstage renal dis ease within 3 years. The fourth patient has normal renal function 3 ye ars after biopsy. Percutaneous renal biopsies during pregnancy in wome n with lupus nephritis provide an accurate histopathologic diagnosis a nd are important in providing appropriate therapy, counseling and prog nosis.