The 13th World Kidney Day 2018 coincides with the International Women's Day, whose theme is "Concerned Kidney Disease and Caring for Women's Health" and provides us with a focus on the health of women, especially the health of women's kidneys.
The prevalence of glomerular disease has a gender difference, and a global histological diagnostic survey shows that the prevalence of glomerular disease in women is 47% and in men 53%.
Female glomerular disease medication
The treatment of glomerular diseases includes immunosuppressive agents, angiotensin receptor blockers, antihypertensive drugs, and management of CKD-related complications. Glomerular disease women should be fully discussed before pregnancy.
Immunosuppressant
Women taking teratogenic immunosuppressive agents (mycophenolate mofetil, methotrexate, and cyclophosphamide) should take active contraception in a safe and effective way of contraception. Women who plan to become pregnant as well as women who may have unwanted pregnancies should avoid the use of these drugs. Alternative immunosuppressants that are safe to use during pregnancy are glucocorticoids, calcineurin inhibitors, azathioprine and hydroxychloroquine. Cyclophosphamide, mycophenolate mofetil, leflunomide and methotrexate have teratogenic effects, contraindication during pregnancy should be at least 3 to 6 months before conception disabled.
Angiotensin receptor blockers and antihypertensive drugs
The use of angiotensin receptor blockers in the second and third trimester of pregnancy is toxic to the fetus and can result in oligohydramnios and neonatal renal failure. Used during early pregnancy, no increase in the incidence of congenital abnormalities. Therefore, glomerular disease in women can continue to use before the diagnosis of pregnancy. Antihypertensive drugs that are safe during pregnancy include methyldopa, labetalol and long-acting nifedipine. The safety of amlodipine is not well understood, but case reports and small studies suggest the drug is not harmful.
Other drugs
There are many reasons for anemia in glomerular diseases, including the worsening of iron deficiency due to menstrual blood loss and the reduction of erythropoietin in CKD. Pregnant women can safely use oral and intravenous iron. During pregnancy can continue to use low-dose aspirin for vascular disease, primary and secondary prevention.
Finally, send a most sincere blessing to women around the world.
Dr.Leo
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