Preeclampsia and Hypertension Disorders of Pregnancy in Women with Kidney Disease.

Hypertensive disorders of pregnancy are a leading cause of maternal and perinatal morbidity and mortality worldwide. Women with CKD are at particularly high risk, with preeclampsia affecting up to 40% of pregnancies. This chapter summarizes the current understanding of hypertensive disorders of pregnancy, with an emphasis on preeclampsia in women with underlying kidney disease. We discuss the epidemiology, pathophysiology, clinical diagnosis, prevention, and management of preeclampsia, highlighting the unique diagnostic and therapeutic challenges posed by preexisting CKD. We review the role of angiogenic biomarkers, including the sFlt1/PlGF ratio which is a ratio of anti/pro angiogenic proteins, in the diagnosis and risk stratification of preeclampsia, current prevention and management strategies, and the importance of post-partum nephrology follow-up.