A 28-year-old woman with pre-eclampsia at 32 weeks develops oliguria (urine output <500 mL in 24 hours). Which statement about renal pathophysiology in pre-eclampsia is correct?
- A Glomerular endotheliosis causes reduced GFR and proteinuria ✓
- B The characteristic renal lesion is membranous nephropathy
- C Acute tubular necrosis is the most common renal pathology
- D Serum creatinine >1.5 mg/dL is required for diagnosis of severe features
Correct answer: A. Glomerular endotheliosis causes reduced GFR and proteinuria
Explanation
The hallmark renal lesion in pre-eclampsia is glomerular endotheliosis, characterized by swollen endothelial cells that narrow the glomerular capillary lumen, reducing GFR and causing proteinuria. Membranous nephropathy is unrelated. Acute tubular necrosis is a complication, not the primary pathology. Serum creatinine >1.1 mg/dL (or doubling from baseline) suffices for severe features, not 1.5 mg/dL.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
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