Kidney Week 2025 Annual Meeting-Glomerular Diseases and Women's Health, Including the Michelle P. Winn, MD, Endowed Lectureship

Video Transcription

Video Summary

The transcript opens by honoring nephrologist-scientist Dr. Michelle Nguyen, credited with identifying a molecular pathway causing familial focal segmental glomerulosclerosis (FSGS) and remembered for her warmth and mentorship. The session then begins: “Glomerular Diseases and Women’s Health,” featuring the Nguyen Endowed Lectureship.<br /><br />Dr. Georgina Piccoli presents on reproductive health and contraception in women with chronic kidney disease (CKD), emphasizing major evidence gaps, clinician discomfort, fragmented care, and underuse of contraception—especially in dialysis patients. She argues reproductive counseling should be embedded into routine nephrology care, highlights drug–contraceptive interactions (e.g., mycophenolate, calcineurin inhibitors), and recommends pragmatic, patient-centered counseling (including emergency contraception, assisted reproduction risks, and culturally sensitive communication). She advocates for “patient-preference” trials to study real-world contraceptive choices and barriers.<br /><br />Dr. Megan Oliverio reviews postpartum kidney physiology and complications. Creatinine typically falls early in pregnancy then rises postpartum; blood pressure peaks in the first postpartum week. Postpartum acute kidney injury/proteinuria differentials include hemorrhage, sepsis, hypertensive disorders, complement-mediated thrombotic microangiopathy (often postpartum), and lupus flares (reduced by hydroxychloroquine). Adverse pregnancy outcomes (preeclampsia, gestational diabetes, preterm birth) predict later CKD and cardiovascular disease, yet postpartum kidney screening is low. She outlines medication safety during breastfeeding (ACE inhibitors like enalapril/captopril generally safe; limited data for newer agents).<br /><br />Renal pathologist Dr. Jean Ho illustrates pregnancy-related lesions: preeclampsia-associated thrombotic microangiopathy/endotheliosis, pregnancy-related glomerulomegaly with secondary FSGS, diabetic glomerulosclerosis, obstructive uropathy/pyelonephritis, and postpartum cortical necrosis (often complement-associated).<br /><br />Dr. Michelle Hladunewich delivers the endowed lecture on glomerular disease in pregnancy: GN markedly increases risks of preeclampsia and preterm birth, especially with proteinuria. Key clinical challenge is distinguishing GN flare/de novo GN from preeclampsia using placental assessment, fetal growth, Dopplers, and angiogenic biomarkers (sFlt-1/PlGF), noting reduced performance in advanced CKD. She reviews pregnancy-safe immunosuppression options and emphasizes aspirin, blood pressure control, and careful timing of delivery.

Asset Subtitle

Moderator(s): Sahar Koubar, Michelle O'Shaughnessy

Presentation(s):

Fertility, Pregnancy Planning, and Contraception in Women with Glomerular Diseases - Giorgina Piccoli
Glomerular Disease Management and Prognosis in the Postpartum Period and Beyond - Andrea Oliverio
Pathology of Pregnancy-Associated Kidney Diseases - Jean Hou
Diagnosis and Management of Pregnancy Complications in Glomerular Diseases: The Michelle P. Winn, MD, Endowed Lectureship - Michelle Hladunewich

ASN gratefully acknowledges Duke University School of Medicine, the school's Division of Nephrology, and several individuals for support of the Winn Endowed Lectureship.

ASN thanks the European Renal Association (ERA) and ERA Ambassador, Dr. Giorgina Piccoli.

Support for all sessions in the Glomerular Diseases Learning Pathway is provided by an educational grant from Vera Therapeutics, Inc.

Meta Tag

Date 11/6/2025

Pathway 1 Glomerular Diseases

Session ID 507937

Keywords

glomerular diseases

women's health

pregnancy and kidney disease

chronic kidney disease (CKD)

contraception counseling

dialysis contraception

drug-contraceptive interactions

mycophenolate teratogenicity

calcineurin inhibitors

postpartum acute kidney injury

preeclampsia

complement-mediated thrombotic microangiopathy

focal segmental glomerulosclerosis (FSGS)

angiogenic biomarkers sFlt-1/PlGF

breastfeeding medication safety