Would you pursue a kidney biopsy in an obese patient with a history of preeclampsia who has nephrotic range proteinuria, negative serologic work up, normal serum albumin, and normal creatinine?

Would you pursue a kidney biopsy in an obese patient with a history of preeclampsia who has persistent nephrotic range proteinuria, negative serologic workup, normal serum albumin, and normal creatinine?

• Yes, I would biopsy after 6 months if proteinuria persists, as preeclampsia alone does not fully explain nephrotic range proteinuria in this clinical context
• Yes, I would biopsy sooner given the degree of proteinuria regardless of the preeclampsia history
• No, I would attribute the proteinuria to obesity-related glomerulopathy and preeclampsia and monitor without biopsy
• Other