Nefropatía lúpica en mujeres gestantes: diagnóstico, tratamiento y seguimiento

Abstract

Systemic Lupus Erythematosus (SLE) is an autoimmune disease that can affect multiple organs, with the renal system being the most compromised. This disease predominates in women of childbearing age, especially in the African and Latin American races. Lupus Nephritis (LN) is the primary cause of renal failure in patients with SLE, and its severity intensifies during pregnancy, increasing maternal-fetal morbidity and mortality. During gestation, the immune system can be altered, raising the risk of SLE flare-ups. However, with early diagnosis, appropriate treatment, and constant monitoring, patients with LN can have successful pregnancies. The aim is to describe the management of lupus nephropathy in pregnant women. Through a narrative study, it was identified that risk factors for LN during pregnancy include high estrogen levels, stress, SLE activity at conception, history of LN, body mass index, and discontinuation of hydroxychloroquine. Renal biopsy is the primary diagnostic method, safely performed up to 20 weeks of gestation. Treatment varies, ranging from hydroxychloroquine to corticosteroids and immunosuppressants. Monitoring requires a multidisciplinary approach with regular evaluations. In conclusion, managing LN in pregnant women is a medical challenge that, with the right approach, can reduce complications and improve prognosis.