Pregnancy-Induced Nephropathy: The Significance of Focal Segmental Glomerulosclerosis

The morphologic alterations of true preeclampsia are well described and distinct. Using available criteria to define reversible pregnancy-induced nephropathy (PIN), the pathologist can offer the clinician information useful in predicting remote renal function and hypertension. True PIN is a usually completely reversible lesion in the nullipara and carries little risk of future hypertension. Nephrosclerotic vascular lesions, however, whether arteriolar, interlobular, or glomerular and resembling focal segmental glomerulosclerosis (FSGS), signify underlying hypertensive disease. This review summarizes information concerning the nature of PIN and also surveys 20 biopsies in women who mainly had severe preeclampsia, often with persistent postpartum hypertension. This material was step-sectioned and specifically reviewed in an effort to find FSGS in women with PIN.