What is the approach to treatment of active lupus nephritis in women planning pregnancy?

Updated: Mar 04, 2019
  • Author: Lawrence H Brent, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Patients with active lupus nephritis should avoid pregnancy, because it may worsen their renal disease and because certain medications used in the treatment may be teratogenic. [48] In women who desire pregnancy, the following approach is advised [49] :

  • A preconception evaluation to establish and inform the patient about pregnancy risks
  • Plan for pregnancy during inactive lupus nephritis
  • Keep the lupus nephritis inactive with the lowest possible dosage of allowed drugs
  • Treat known risk factors (hypertension, antiphospholipid and antibodies)
  • Monitor closely during and after pregnancy to rapidly identify and treat SLE flares and obstetric complications

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