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- Title
Acute kidney injury in pregnancy and the use of non-steroidal anti-inflammatory drugs.
- Authors
Wiles, Kate S; Banerjee, Anita
- Abstract
Key content: Serum creatinine falls in normal pregnancy and a new serum creatinine level above 90 micromol/l in pregnancy should trigger investigation for acute kidney injury.Causes of acute kidney injury in pregnancy include pre‐eclampsia, HELLP (haemolysis, elevated liver enzymes and low platelet count), microangiopathic haemolytic anaemia, acute fatty liver of pregnancy, lupus nephritis, renal tract obstruction and drug use.Non‐steroidal anti‐inflammatory drugs (NSAIDs) can cause acute kidney injury as well as cardiovascular and gastrointestinal adverse effects.NSAIDs should be avoided in pre‐eclampsia, volume depletion, acute kidney injury and chronic kidney disease.When NSAIDs are used, ibuprofen has the best safety profile. It should be used at the lowest effective dose and discontinued as soon as possible. Learning objectives: To be able to diagnose acute kidney injury in pregnancy and understand the importance of supportive treatment.To gain an overview of the possible causes of acute kidney injury in pregnancy and their management.To appreciate the adverse effect profile of NSAIDs and be able to modify prescribing for high‐risk patients. Ethical issues: When prescribing in pregnancy and the postpartum period the risks and benefits of treatment must be considered for each individual patient.Acute kidney injury in pregnancy is more prevalent in low and middle income countries where there is often a lower provision of supportive renal care.
- Subjects
TREATMENT of acute kidney failure; THERAPEUTIC use of monoclonal antibodies; PREECLAMPSIA; THROMBOTIC thrombocytopenic purpura treatment; IMMUNOSUPPRESSIVE agents; FATTY liver; HELLP syndrome; ACUTE kidney failure; CREATININE; FLUID therapy; HEMOLYTIC-uremic syndrome; KIDNEY diseases; NONSTEROIDAL anti-inflammatory agents; PLASMA exchange (Therapeutics); POSTNATAL care; SYSTEMIC lupus erythematosus; THERAPEUTICS; PREGNANCY; DIAGNOSIS
- Publication
Obstetrician & Gynaecologist, 2016, Vol 18, Issue 2, p127
- ISSN
1467-2561
- Publication type
Article
- DOI
10.1111/tog.12257