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How would you approach the management of a patient who develops primary FSGS during pregnancy?

2 Answers
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Nephrology · Johns Hopkins University
Answered on
  1. Would do supportive care regardless, low salt diet, BP control to <130/80, but avoid hypotension to decrease placental hypoperfusion, AC with Lovenox to decrease VTE risk if UPCR >10 grams with albumin <2.5, and ASA 81 mg starting after the first trimester to reduce preeclampsia risk.
  2. For progressi...

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Mednet Member
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Nephrology · Renal Medicine Associates
Answered on

Supportive care, low salt, BP control, ASA 81 mg/g. Can use non-DHP CCBs like diltiazem for reduction in proteinuria if needed. Not great data, but it does have anti-proteinuric effects. For IS: prednisone or CNIs. Not great data for AZA here. Would avoid ACEi/ARB/CYC/MMF.

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