Clinical Crossroads | Clinician's Corner

A 43-Year-Old Woman With Chronic Renal Insufficiency

Glenn M. Chertow, MD, MPH, Discussant
JAMA. 2004;291(10):1252-1259. doi:10.1001/jama.291.10.1252.
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DR SHIP: Mrs C is a 43-year-old woman who has had renal insufficiency for 23 years. She works as a nurse assistant part time and lives with her husband and son outside Boston. She has indemnity insurance.

Mrs C was first found to have protein in her urine when she was 20 years of age. No intervention was made at that time. She was followed up clinically until her 30s, when a new internist referred her to a kidney specialist. In 1995, she underwent a kidney biopsy and was diagnosed as having focal segmental glomerular sclerosis. Soon after, she became pregnant and was told that her pregnancy might speed the progression of her kidney disease. She chose to proceed and had a healthy pregnancy and delivery without any symptoms or complications.

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