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NDT Advance Access originally published online on May 25, 2007
Nephrology Dialysis Transplantation 2007 22(8):2395-2397; doi:10.1093/ndt/gfm302
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© The Author [2007]. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
(Section Editor: A. Meyrier)

Renal replacement therapy for acute kidney injury in pregnancy

Katherine Barraclough, Ercole Leone2 and Anthony Chiu1

1Department of Nephrology and 2Department of Urology, St Paul's Hospital, Vancouver, Canada.

Correspondence and offprint requests to: K. A. Barraclough, Department of Nephrology, St Paul's Hospital, 1081 Burrard Street, Providence Building, 6th Floor, Room 6010A Vancouver, British Colombia, V6Z1Y6, Canada. Email: arbieb@hotmail.com

Keywords: acute kidney injury; haemodialysis; pregnancy; pyelonephritis; renal replacement therapy; urosepsis

The first 150 words of the full text of this article appear below.



   Introduction
 
With the liberalization of abortion laws and improved obstetric care in developed countries, acute kidney injury in pregnancy is now an uncommon occurrence [1,2]. Current incidence rates range between 1% and 2.8% [2]. Acute kidney injury requiring renal replacement therapy (RRT) occurs in <1 in 10 000–15 000 pregnancies [1]. Subsequently, there is little to guide the management of such patients.

We describe a case of pyelonephritis in pregnancy that led to critical illness and acute kidney injury. It demonstrates pregnancy-induced anatomical and physiological alterations and their effect on diagnosis and management. It serves as a basis for discussion regarding the most appropriate form of RRT in this setting.

Case report
A 27-year-old previously well Indian female, 22 weeks pregnant, was admitted with fever, right flank pain and pyuria. Her pregnancy had been uncomplicated prior to admission, as had two previous pregnancies. Medications included . . . [Full Text of this Article]



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