A woman with GN presenting during pregnancy.

The combination of kidney disease and pregnancy has long been recognized as a high-risk situation. When renal disease is recognized for the first time during pregnancy, it presents unique problems for both the obstetric and the renal teams. Particularly difficult can be distinguishing preeclampsia from preexisting kidney disease in women presenting for the first time with hypertension, proteinuria, and reduced GFR during pregnancy. Decision-making regarding performing a kidney biopsy and treatment of glomerular disease during pregnancy is often much more complicated by safety concerns for both the mother and the developing fetus.