Why kidneys fail post-partum: a tubulocentric viewpoint

Kidneys may fail post-partum in a number of circumstances due, for example, to post-partum haemorrhage, preeclampsia, amniotic fluid embolism or septic abortion. All these conditions in pregnancy and post partum represent a threat not only to the endothelium but also to the renal tubular epithelium,...

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Bibliographic Details
Published in:Journal of nephrology 2018-10, Vol.31 (5), p.645-651
Main Authors: Villie, Patricia, Dommergues, Marc, Brocheriou, Isabelle, Piccoli, Giorgina Barbara, Tourret, Jérôme, Hertig, Alexandre
Format: Article
Language:English
Subjects:
Gynecology and obstetrics
Human health and pathology
Life Sciences
Medicine & Public Health
Nephrology
Obstetric Nephrology
Review
Urology
Urology and Nephrology
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Summary:Kidneys may fail post-partum in a number of circumstances due, for example, to post-partum haemorrhage, preeclampsia, amniotic fluid embolism or septic abortion. All these conditions in pregnancy and post partum represent a threat not only to the endothelium but also to the renal tubular epithelium, and as such may lead to rapid and also irreversible impairment of the renal function. This paper is a non-systematic review of the literature and of our experience, in which we discuss the main open issues on kidney disease in pregnancy and following delivery, in particular as regards tubular damage, with the aim to help reasoning on acute kidney injury (AKI) following delivery. The review will emphasize the often under-estimated importance of the tubular epithelium in the peri-partum period and will: (1) describe the main characteristics of the renal tissues around delivery; (2) define pregnancy-related AKI according to recent Kidney Disease/Improving Global Outcome (KDIGO) guidelines; (3) discuss the most common circumstances of post-partum AKI; and (4) describe the input expected from urinalysis, renal imaging and kidney biopsy.
ISSN:1121-8428
1724-6059
DOI:10.1007/s40620-018-0488-0