Dr. Maria Gonzalez Suarez, is an Assistant Professor in Nephrology and recently authored the article “Renal Disorders in Pregnancy: Core Curriculum 2019” in the American Journal of Kidney Diseases. Here, Dr. Gonzalez Suarez shares about the article, her recently-awarded grant by the Mississippi Center for Clinical and Translational Research, and her take on balancing a career and family.
Tell us about your article.
The article is part of a “Core Curriculum” series in the journal, which aims to give trainees in nephrology a strong knowledge base of core topics in the specialty and cites key references that led to current clinical approaches. It is intended to be an easy read about chronic kidney disease (CKD) in pregnancy. With the use of clinical cases, we explore different conditions that affect the kidneys during pregnancy, giving the reader an idea of clinical scenarios they may encounter, how to recognize them and how to treat the medical conditions. Read the full article here.
Why is this topic important?
Pregnancy in CKD is a topic that every internist should know something about. Women with kidney disorders face several challenges in pregnancy due to increased physiologic demands on the kidneys and risk for kidney disease progression. They suffer from increased risk for complications such as preeclampsia and preterm delivery. Unfortunately, the number one cause of maternal death in America is due to preeclampsia and raising awareness on this topic is of major interest in nephrology. It is important to recognize preeclampsia and to be able to differentiate it from other conditions that could be affecting the kidneys which are sometimes recognized during pregnancy, as patients are ideally monitored closely.
You recently spoke at the Mississippi transplant symposium about pregnancy outcomes in advanced CKD and kidney transplant recipients. Tell us more about that.
In general, women with advanced CKD have difficulties becoming pregnant, as their fertility is affected by the kidney disease. Furthermore, if they become pregnant, patients with advanced CKD are at higher risks of maternal and fetal complications. Once women receive a kidney transplant, they have better chances to become pregnant, as their fertility improves after transplantation. It is important for this population to plan their pregnancies with the help of their transplant team since some immunosuppressive medications are contraindicated during pregnancy and these should be changed to other medications that can be used during this period.
Speaking of pregnancy, you are also a mother. What is your secret to balancing a full career and a family?
Motherhood is a very important factor in my life. Unfortunately, there is no secret to balance it out (or at least I have not found it yet). Once you choose to become a mother and to continue to work full time in academic medicine, you will need all the support from your partner, family and friends you can get. Being humble enough to recognize when you need help, and ask for it is important. It also helps to have understanding colleagues that also help you out along the way when needed. Medical training prepares you to become a multitasker, but you must accept that sometimes even when you try hard, there are events that will be missed and sacrifices will be made. At the end of the day, raising a family is all worth it. Thanks be to God for daycare and coffee!
Congratulations on being awarded with a grant from the Mississippi Center for Clinical and Translational Research (MCCTR) to begin a pilot project on hypertension and cardiovascular diseases. Tell us more about it.
We are planning to measure autoantibodies against an angiotensin II receptor. These antibodies trigger the angiotensin II type 1 receptor and raise blood pressure. This is thought to be the main mechanism of hypertension in preeclampsia. It could also be one of the mechanisms of hypertension and cardiovascular disease in chronic kidney disease. We will measure these autoantibodies in a population of end stage kidney disease and search for an association to cardiovascular events in this population. This project is expected to generate preliminary data to help get funding for a larger study in this topic.