I recommed preeclamtic women to be monitored by their Primary Care Physician just performing an albumin/creatinine ratio in a spot urine sample between 4 and 8 weeks after delivery. The vast majority of cases become normoalbuminuric and no treatment is needed. Nevertheless, I use to recommend remote assessment, i.e. every 2 years, of cardiovascular risk stratification.

Thanks Manuel,

In fact my concern was about those who keep abnormal UAE 2 or 3 months after delivery. Would you go for more exploration (renal biopsy?) or you just continue a follow-up every 3-6 months?

Also about cardiovascular risk stratification, would you consider albuminuria as a risk factor that needs intervention ?

The resolution of pre-eclampsia-related proteinuria should occur by 12 weeks postpartum, if the proteinuria was, indeed, de novo and gestational.  Once the woman's blood pressure has resolved (until which time I would see her at least weekly), then I would arrange a follow-up at around 12 weeks to ensure that proteinuria has settled if it outlasts the hypertension, using either a protein:creatinine or albumin:creatinine ratio.

In terms ACEI use during lactation, these are safe in breastfeeding.