Nothing terrifies nephrologists, quite like the consult from labor and delivery. And one of the most vexing questions is, “Is this preeclampsia or proteinuric CKD or a lupus flare?” Perhaps a newly approved blood test will be able to shed light on this clinical conundrum. The ratio of soluble fms-like tyrosine kinase 1 (sFlt-1) to placental growth factor (PlGF) has appeared predictive of severe preeclampsia. The PRAECIS trial evaluated this is a prospective manner. Join the filtrate as we do a truly incompetent job discussing this study.