15th July 2024

A 38-year-old female who is 23 weeks pregnant has known chronic kidney disease secondary

A 38-year-old female who is 23 weeks pregnant has known chronic kidney disease secondary to ANCA associated vasculitis. She has residual renal scarring and had a pre-pregnancy creatinine of 176µmol/l (eGFR 32) and a uPCR of 71 mg/mmol. Her vasculitis has been stable on maintenance azathioprine and prednisolone for 2 years. She was started on aspirin 150 mg once daily on conception. On presentation, she had a blood pressure of 155/78, with a urine dipstick showing 2+ protein and no haematuria. She has new ankle swelling. Her bloods show a creatinine of 214µmol/l and a uPCR of 221 mg/mmol. What is the most likely diagnosis?

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