Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Drugs
Published in: Drugs 13/2001

01-11-2001 | Review Article

Pregnancy and Renal Failure

The Case for Application of Dosage Guidelines

Authors: Dr Frieder Keller, Martin Griesshammer, Ulla Häussler, Wolfgang Paulus, Anke Schwarz

Published in: Drugs | Issue 13/2001

Login to get access

Abstract

Pregnancies in women with renal disease, undergoing dialysis treatment or with kidney transplants are increasingly observed. Serious problems with drug dose adjustment may arise in pregnant women with renal impairment. This review gives a practical overview on the risks of drug use during gestation, the recommended drugs of choice (e.g. methyldopa, cyclosporin), and provides some proposals for dosage adjustments in pregnant women with renal impairment.
In normal pregnancy, the glomerular filtration rate and plasma volume increase, whereas plasma protein binding and liver function may be impaired. An increase in dosage is needed for cyclosporin and for methadone because of increased hepatic clearance. The dosage of erythropoetin must be increased because of lower potency in pregnant women. Little more is known on the impact of gestation on drug dose, since pharmacokinetic studies are rarely done in pregnant women.
The dosages of magnesium, lithium and morphine must be reduced in renal impairment. Dose adjustment to renal function is critical and is essential for anti-infective agents (e.g. ceftazidime, ganciclovir). Basing drug dose on estimated creatinine clearance might be the most practical solution in pregnant women with renal impairment.
Literature
1.
Little BB. Pharmacokinetics during pregnancy: evidence-based maternal dose formulation. Obstet Gynecol 1999; 93: 858–68PubMedCrossRef
2.
Donati S, Baglio G, Spinelli A, et al. Drug use in pregnancy among Italian women. Eur J Clin Pharmacol 2000, 56: 323–8PubMedCrossRef
3.
Berkovitch M, Elbirt D, Addis A, et al. Fetal effects of meto-clopramide therapy for nausea and vomiting of pregnancy [letter]. N Engl J Med 2000 Aug; 343: 445–6PubMedCrossRef
4.
Berkovitch M, Segel-Socher I, Greenberg R, et al. First trimester exposure to cefuroxime: a prospective cohort study. Br J Clin Pharmacol 2000, 50: 161–5PubMedCrossRef
5.
Lacroix I, Damase-Michel C, Lapeyre-Mestre M, et al. Prescription of drugs during pregnancy in France. Lancet 2000; 356: 1735–6PubMedCrossRef
6.
Davison JM, Dunlop W. Renal hemodynamics and tubular function in normal human pregnancy. Kidney Int 1980; 18: 152–61PubMedCrossRef
7.
Loebstein R, Lalkin A, Addis A, et al. Pregnancy outcome after gestational exposure to ternadine: a multicenter, prospective controlled study. J Allerg Clin Immunol 1999 Nov; 104: 953–6CrossRef
8.
Doll DC, Ringenberg OS, Yarbro JW. Antineoplastic agents and pregnancy. Semin Oncol 1989; 16: 337–46PubMed
9.
Roubenoff R, Hoyt J, Petri M, et al. Effects of antiinflammatory and immunosuppressive drugs on pregnancy and fertility. Semin Arthritis Rheum 1988 Nov; 18: 88–110PubMedCrossRef
10.
Armenti VT, Ahlswede KM, Ahlswede BA, et al. Variables affecting birthweight and graft survival in 197 pregnancies in cyclosporine-treated female kidney transplant recipients. Transplantation 1995 Feb 27; 59(4): 476–9PubMed
11.
Thomas AG, Burrows L, Knight R, et al. The effect of pregnancy on cyclosporine levels in renal allograft patients. Obstet Gynecol 1997 Dec; 90(6): 916–9PubMedCrossRef
12.
Jarvis MA, Wu Pong S, Kniseley JS, et al. Alterations in methadone metabolism during late pregnancy. J Addict Dis 1999; 18(4): 51–61PubMedCrossRef
13.
Riva E, Farina P, Tognoni G, et al. Pharmacokinetics of furo-semide in gestosis of pregnancy. Euro J Clin Pharmacol 1978 Dec; 18: 361–6CrossRef
14.
Jones DC, Hayslett JP. Outcome of pregnancy in women with moderate or severe renal insufficiency. N Engl J Med 1996 Jul 25; 335(4): 226–32PubMedCrossRef
15.
Bar J, Ben-Rafael Z, Padoa A, et al. Prediction of pregnancy outcome in subgroups of women with renal disease. Clin Nephrol 2000; 53: 437–44PubMed
16.
Deubner H, Wagnild JP, Wener MH, et al. Glomerulonephritis with anti-glomerular basement membrane antibody during pregnancy: potential role of the placenta in amelioration of disease. Am J Kidney Dis 1995 Feb; 25(2): 330–5PubMedCrossRef
17.
Dolkart LA, Tapia LA. Idiopathic rapidly progressive (crescentic) glomerulonephritis in pregnancy. Am J Perinatol 1996 May; 13(4): 199–201PubMedCrossRef
18.
Jungers P, Houillier P, Forget D, et al. Influence of pregnancy on the course of primary chronic glomerulonephritis. Lancet 1995 Oct 28; 346(8983): 1122–4PubMedCrossRef
19.
Abe S. The influence of pregnancy on the long-term renal prognosis of IgA nephropathy. Clin Nephrol 1994 Feb; 41: 61–4PubMed
20.
Lindheimer MD, Katz AI. Gestation in women with kidney disease; prognosis and management. Clin Obstet Gynaecol 1994; 8: 387–404
21.
Hemmelder MH, de Zeeuw D, Fidler V, et al. Proteinuria: a risk factor for pregnancy-related renal function decline in primary glomerular disease? Am J Kidney Dis 1995 Jul; 26(1): 187–92PubMedCrossRef
22.
Kozlowska-Boszko B, Durlik M, Kuczynska-Sicinska J, et al. Predictor of transplanted kidney deterioration following pregnancy—daily urine protein loss or serum creatinine concentration? Ann Transplant 1996; 1(4): 30–1PubMed
23.
Holley JL, Bernardini J, Quadri KH, et al. Pregnancy outcomes in a prospective matched control study of pregnancy and renal disease. Clin Nephrol 1996 Feb; 45: 77–82PubMed
24.
Chan WS, Okun N, Kjellstrand CM. Pregnancy in chronic dialysis: a review and analysis of the literature. Int J Artif Organs 1998 May; 21(5): 259–68PubMed
25.
Bagon JA, Vernaeve H, De Muylder X, et al. Pregnancy and dialysis. Am J Kidney Dis 1998 May; 31(5): 756–65PubMedCrossRef
26.
Hou S, Firanek C. Management of the pregnant dialysis patient. Adv Ren Replace Ther 1998 Jan; 5(1): 24–30PubMed
27.
Reister F, Reister B, Heyl W, et al. Dialysis and pregnancy — a case report and review of the literature. Ren Fail 1999 Sep; 21(5): 533–9PubMedCrossRef
28.
Bar J, Fisch B, Wittenberg C, et al. Prednisone dosage and pregnancy outcome in renal allograft recipients. Nephrol Dial Transplant 1997 Apr; 12(4): 760–3PubMedCrossRef
29.
Armenti VT, Radomski JS, Moritz MJ, et al. Report from the National Transplantation Pregnancy Registry (NTPR): outcomes of pregnancy after transplantation. Clin Transplant 1997: 101–12
30.
Hou S. Pregnancy in chronic renal insufficiency and end-stage renal disease. Am J Kidney Dis 1999 Feb; 33(2): 235–52PubMedCrossRef
31.
Furman B, Wiznitzer A, Hackmon R, et al. Multiple pregnancies in women after renal transplantation: case report that rises a management dilemma. Eur J Obstet Gynecol Reprod Biol. 1999 May; 84(1): 107–10PubMedCrossRef
32.
Saber LT, Duarte G, Costa JA, et al. Pregnancy and kidney transplantation: experience in a developing country. Am J Kidney Dis 1995 Mar; 25(3): 465–70PubMedCrossRef
33.
Hussey MJ, Pombar X. Obstetric care for renal allograft recipients or for women treated with hemodialysis or peritoneal dialysis during pregnancy. Adv Ren Replace Ther 1998 Jan; 5(1): 3–13PubMed
34.
Resch B, Mache CJ, Windhager T, et al. FK 506 and successful pregnancy in a patient after renal transplantation. Transplant Proc 1998 Feb; 30(1): 163–4PubMedCrossRef
35.
Sturgiss SN, Davison JM. Effect of pregnancy on the long-term function of renal allografts: an update. Am J Kidney Dis 1995 Jul; 26(1): 54–6PubMedCrossRef
36.
Miller BW, Howard TK, Goss JA, et al. Renal transplantation one week after conception. Transplantation 1995 Dec 15; 60(11): 1353–4PubMed
37.
38.
Hulton SA, Kaplan BS. Renal dysplasia associated with in utero exposure to gentamicin and corticosteroids. Am J Med Genet 1995 Jul 31; 58(1): 91–3PubMedCrossRef
39.
Robinson AJ, Ridgway GL. Concurrent gonococcal and chlamydial infection. Drugs 2000 Apr; 59: 801–13PubMedCrossRef
40.
Thakur CP, Singh RK, Hassan SM, et al. Amphotericin B deoxycholate treatment of visceral leishmaniasis with newer modes of administration and precautions: a study of 938 cases. Trans R Soc Trop Med Hyg 1999 May–Jun; 93(3): 319–23PubMedCrossRef
41.
Miller JM, Martin DH. Treatment of chlamydia trachomatis infections in pregnant women. Drugs 2000 Sep; 60: 597–605PubMedCrossRef
42.
Goldenberg RL, Hauth JC, Andrews WW. Intrauterine infection and preterm delivery. N Engl J Med 2000 May; 342: 1500–7PubMedCrossRef
43.
Hernandez-Diaz S, Werler MM, Walker AM, et al. Folic acid antagonists during pregnancy and the risk of birth defects. N Engl J Med 2000 343: 1608–14PubMedCrossRef
44.
Jick SS. Pregnancy outcomes after maternal exposure to fluconazole. Pharmacotherapy 1999 Feb; 19(2): 221–2PubMedCrossRef
45.
Sorensen HAT, Larsen H, Jensen ES, et al. Safety of metroni-dazole during pregnancy: a cohort study of risk of congenital abnormalities, preterm delivery and low birth weight in 124 women. J Antimicrob Chemother 1999; 44: 854–5PubMedCrossRef
46.
Sorensen HAT, Nielsen GL, Olesen C, et al. Risk of malformations and other outcomes in children exposed to fluconazole in utero. Br J Clin Pharmacol 1999 Aug; 48(2): 234–8PubMedCrossRef
47.
Czeizel AE, Rockenbauer M, Sorensen HT, et al. A population-based case-control teratologic study of furazidine, a nitrofuran-derivative treatment during pregnancy. Clin Nephrol 2000; 53: 257–63PubMed
48.
Bar-Oz B, Moretti ME, Bishai R, et al. Pregnancy outcome after in utero exposure to itraconazole: a prospective cohort study. Am J Obstet Gynecol 2000 Sep; 183: 617–20PubMedCrossRef
49.
50.
Czeizel AE, Rockenbauer M, Sorensen HAT, et al. Teratogenic evaluation of oxacillin. Scand J Infect Dis 1999; 31: 311–2PubMedCrossRef
51.
Shulmann CE, Dorman EK, Dutts F, et al. Intermittent sul-phadoxine-pyrimethamine to prevent severe anaemia secondary to malaria in pregnancy: a randomised placebo-controlled trial. Lancet 1999; 353: 632–6CrossRef
52.
Anonymus. Quinolones and pregnancy: worrying animal findings, few clinical data. Prescr Int 1999 Feb 8; (39): 29–31
53.
Anonymus. Recommendations for antiretroviral therapy during pregnancy: prevention for the child; treatment for the mother. Prescrire Int 1999 Feb 8; (39): 24–8
54.
Hoffman RS. Thallium poisoning during preganancy: a case report and comprehensive literature review. Clin Toxicol 2000; 38: 767–75CrossRef
55.
Reyes MP, Ostrea EM, Cabinian AE, et al. Vancomycin during pregnancy: does it cause hearing loss or nephrotoxicity in the infant? Am J Obstet Gynecol 1989 Oct; 161: 977–81PubMed
56.
57.
Johnson MA, Moore KH, Yuen GJ, et al. Clinical pharmacokinetics of lamivudine. Clin Pharmacokinet 1999 Jan; 36(1): 41–66PubMedCrossRef
58.
Mirochnick M, Clarke DF, Dorenbaum A. Nevirapine; pharmacokinetic considerations in children and pregnant women. Clin Pharmacokinet 2000; 39: 281–93PubMedCrossRef
59.
Honein MA, Paulozzi LJ, Cragan JD, et al. Evaluation of selected characteristics of pregnancy drug registries. Teratology 1999 Dec; 60(6): 356–64PubMedCrossRef
60.
Wiktor SZ, Ekpini E, Karon JM, et al. Short.-course oral zidovudine for prevention of mother-to-child transmission of HIV-1 in Abidjan, Cote d’Ivoire: a randomised trial. Lancet 1999 Mar; 353(9155): 781–5PubMedCrossRef
61.
Rodman JH, Flynn PM, Robbins B, et al. Systemic pharmacokinetics and cellular pharmacology of zidovudine in human immunodeficieny virus type 1-infected women and newborn infants. J Infect Dis 1999 Dec; 180: 1844–50PubMedCrossRef
62.
Tomlinson AJ, Campbell J, Walker JJ, et al. Malignant primary hypertension in pregnancy treated with lisinopril. Ann Pharmacother. 2000 Feb; 34(2): 180–2PubMedCrossRef
63.
Saji H, Yamanaka M, Hagiware A, et al. Losartan and fetal toxic effects [letter]. Lancet 2001; 357: 363PubMedCrossRef
64.
Tremlett MR, Kelly PJ, Parkins J, et al. Low-dose clonidine infusion during labor. Br J Anaesth 1999 Aug 83(2): 257–61PubMedCrossRef
65.
Suonio S, Saarikoski S, Tahvanainen K, et al. Acute effects of dihydralazine mesylate, furosemide, and metoprolol on maternal hemodynamics in pregnancy-induced hypertension. Am J Obstet Gynecol 1986 Jul; 155: 122–5PubMed
66.
Gudmundsson S, Gennser G, Marsal K. Effects of hydralazine on placental and renal circulation in pre-eclampsia. Acta Obstet Gynecol Scand 1995 Jul; 74(6): 415–8PubMedCrossRef
67.
Lu JF, Nightingale CH. Magnesium sulfate in eclampsia and pre-eclampsia. Clin Pharmacokinet 2000 Apr; 38: 306–14CrossRef
68.
69.
Armenti VT, Moritz MJ, Davison JM. Drug safety issues in pregnancy following transplantation and immunosuppression: effects and outcomes. Drug Saf 1998 Sep; 19(3): 219–32PubMedCrossRef
70.
Armenti VT, Moritz MJ, Davison JM. Medical management of the pregnant transplant recipient. Adv Ren Replace Ther 1998 Jan; 5(1): 14–23PubMed
71.
Koren G. Antimalarial drugs for rheumatoid disease during pregnancy. Can Fam Physician 1999 Dec; 45: 2869–70PubMed
72.
Ghandour FZ, Knauss TC, Hricik DE. Immunosuppressive drugs in pregnancy. Adv Ren Replace Ther 1998 Jan; 5(1): 31–7PubMed
73.
Enns GM, Roeder E, Chan RT, et al. Apparent cyclophosph-amide (cytoxan) embryopathy: a distinct phenotype? Am J Med Genet 1999 Sep 86(3): 237–41PubMedCrossRef
74.
Parke A, West B. Hydroxychloroquine in pregnant patients with systemic lupus erythematosus. J Rheumatol 1996 Oct; 23: 1715–8PubMed
75.
Branch DW, Peaceman AM, Druzin M, et al. A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. The Pregnancy Loss Study Group. Am J Obstet Gynecol 2000 Jan; 182 (1 Pt 1): 122–7PubMedCrossRef
76.
Prakash A, Jarvis B. Leflunomide: a review of its use in active rheumatoid arthritis. Drugs 1999 Dec; 58(6): 1137–64PubMedCrossRef
77.
Pergola PE, Kancharla A, Riley DJ. Kidney transplantation during the first trimester of pregnancy: immunosuppression with mycophenolate mofetil, tacrolimus, and prednisone. Transplantation 2001; 71: 994–7PubMedCrossRef
78.
Backos M, Rai R, Baxter N, et al. Pregnancy complications in women with recurrent miscarriage associated with antiphospholipid antibodies treated with low dose aspirin and heparin. Br J Obstet Gynaecol 1999; 106: 102–7PubMedCrossRef
79.
Umesaki N, Ueda K, Tanaka T, et al. Favorable response to heparin in a pregnant woman with possible glomerular thrombosis as a complication of systemic lupus erythematosus and anti-phospholipid antibody syndrome. Osaka City Med J 1997 Jun; 43(1): 89–94PubMed
80.
Hunt BJ, Doughty HA, Majumdar G, et al. Thrombo-prophylaxis with low molecular weight heparin (fragmin) in high risk pregnancies. Thromb Haemost 1997; 77: 39–43PubMed
81.
Chan WS, Ray JG. Low molecular weight heparin use during pregnancy: issues of safety and practicality. Obstet Gynecol Surv 1999 Oct; 54(10): 649–54PubMedCrossRef
82.
Huhle G, Geberth M, Hoffmann U, et al. Management of heparin-associated thrombocytopenia in pregnancy with subcutaneous r-hirudin. Gynecol Obstet-Invest 2000; 49: 67–9PubMedCrossRef
83.
Vitale N DeFeo M, DeSanto LS, Pollice A, et al. Dose-dependent fetal complications of warfarin in pregnant women with mechanical heart valves. J Am Coll Cardiol 1999 May; 33(6): 1637–41PubMedCrossRef
84.
Samren EB, van Duijn CM, Christiaens GC, et al. Antiepileptic drug regimens and major congenital abnormalities in the offspring. Ann Neurol 1999 Nov; 46: 739–46PubMedCrossRef
85.
Briggs GG, Freeman RK, Yaffe SJ. Drugs in pregnancy and lactation. 5th ed. Baltimore: Williams & Wilkins; 1999, (CD-ROM)
86.
Mazzotta P, Magee LA. A risk-benefit assessment of pharmacological and nonpharmacological treatments for nausea and vomiting of pregnancy. Drugs 2000 Apr; 59: 781–800PubMedCrossRef
87.
Wisner KL, Gelenberg AJ, Leonard H, et al. Pharmacologic treatment of depression during pregnancy. J Am Med Assoc 1999 Oct 282(13): 1264–9CrossRef
88.
Diav-Citrin O, Okotore B, Lucarelli K, et al. Pregnancy outcome following first-trimester exposure to zopiclone: a prospective controlled cohort study. Am J Perinatal 1999; 16: 157–60CrossRef
89.
Ruigomez A, Rodriguez LAG, Cattaruzzi C, et al. Use of cimet-idine, omeprazole, and ranitidine in pregnant women and pregnancy outcomes. Am J Epidemiol 1999 Sep; 150(5): 476–81PubMedCrossRef
90.
Sorensen HT, Nielsen GL, Christensen K, et al. Birth outcome following maternal use of metoclopramide. Br J Clin Pharmacol 2000; 49: 264–8PubMedCrossRef
91.
Nielsen GL, Sorensen HT, Thulstrup AM, et al. The safety of proton pump inhibitors in pregnancy. Aliment Pharmacol Ther 1999 Aug; 13(8): 1085–9PubMedCrossRef
92.
Bishai R, Arbour L, Lyons C, et al. Intrauterine exposure to clomiphene and neonatal persistent hyperplastic primary vitreous. Teratology 1999 Sep; 60(3): 143–5PubMedCrossRef
93.
Komhoff M, Wang JL, Cheng HF, et al. Cyclooxygenase-2-se-lective inhibitors impair glomerulogenesis and renal cortical development. Kidney Int 2000 Feb; 57(2): 414–22PubMed
94.
Ray JG. DDAVP use during pregnancy: an analysis of its safety for mother and child. Obstet Gynecol Surv 1998 Jul; 53(7): 450–5PubMedCrossRef
95.
Nasu K, Yoshimatsu J, Anai T, et al. Low-dose dopamine in treating acute renal failure caused by preeclampsia. Gynecol Obstet Invest 1996; 42(2): 140–1PubMedCrossRef
96.
Fagih B, Sami M. Safety of antiarrhythmics during pregnancy: case report and review of the literature. Can Cardiol 1999 Jan; 15(1): 113–7
97.
Wisner KL, Gelenberg AJ, Leonard H, et al. Pharmacologic treatment of depression during pregnancy. JAMA 1999 Oct 6; 282(13): 1264–9PubMedCrossRef
98.
99.
Langer O, Conway DL, Berkus MD, et al. A comparison of glyburide and insulin in women with gestational diabetes mellitus. N Engl J Med 2000, 343: 1134–8PubMedCrossRef
100.
Henck JW, Craft WR, Black A, et al. Pre- and postnatal toxicity of the HMG-CoA reductase inhibitor atorvastatin in rats. Toxicol Sci 1998 Jan; 41: 88–99PubMedCrossRef
101.
Stephan D, Welsch M, Chapatte D, et al. Deep venous thrombosis during pregnancy: long-term treatment with low molecular weight heparin [article in French]. Presse Med 1999 Nov 6; 28(34): 1880PubMed
102.
Letontourier P. How many daily insulin injections for the pregnant diabetic woman? Presse Med 1999 Dec; 28(38): 2104–5
103.
Griesshammer M, Bergmann L, Pearson T. Fertility, pregnancy and the management of myeloproliferative disorders. Baillieres Clin Haematol 1998 Dec; 11(4): 859–74PubMedCrossRef
104.
Marcus WL. Lithium: a review of its pharmcokinetics, health effects, and toxicology. J Environ Pathol Toxicol Oncol 1994; 13: 73–9PubMed
105.
Hellmuth E, Damm P, Molsted-Pedersen L. Oral hypoglycaemic agents in 118 diabetic pregnancies. Diabet Med 2000 Jul; 17: 507–11PubMedCrossRef
106.
Wang EC. Methadone treatment during pregnancy. J Obstet Gynecol Neonatal Nurs 1999 Nov–Dec; 28(6): 615–22PubMedCrossRef
107.
Fischer G, Jagsch R, Eder H, et al. Comparison of methadone and slow-release morphine maintenance in pregnant addicts. Addiction 1999 Feb; 94(2): 231–9PubMedCrossRef
108.
Bernstein J, Werner AL, Verani R. Nonsteroidal anti-inflammatory drug fetal nephrotoxicity. Pediatr Dev Pathol 1998 Mar–Apr; 1(2): 153–6PubMedCrossRef
109.
Momotani N, Noh JY, Ishikawa N, et al. Effects of propylthiouracil and methimazole on fetal thyroid status in mothers with Grave’s hyperthyroidism. J Clin Endocrin Metabol 1997 Nov; 82: 3633–6CrossRef
110.
Thuermann PA, Steioff A. Drug treatment in pregnancy. Int J Clin Pharmacol Therap 2001; 39: 185–91
111.
112.
113.
Olofsson P, Krutzen E, Nilsson-Ehle P. Iohexol clearance for assessment of glomerular filtration rate in diabetic pregnancy. Eur J Obstet Gynecol Reprod Biol 1996 Jan; 64: 63–7PubMedCrossRef
114.
Keller F, Giehl M, Frankewitsch T, et al. Pharmacokinetics and drug dosage adjustment to renal impairment. Nephrol Dial Transplant 1995; 10: 1516–20PubMed
115.
Quadri KH, Bernardini J, Greenberg A, et al. Assessment of renal function during pregnancy using random urine protein to creatinine ratio and Cockcroft-Gault formula. Am J Kidney Dis 1994 Sep; 24: 416–20PubMed
116.
Wang Y, Livingston E, Paul S, et al. Pharmacokinetics of didanosine in antepartum and postpartum human immunodeficiency virus-infectd pregnant women and their neonates: an AIDS clinical trials group study. J Infect Dis 1999 Nov; 180: 1536–41PubMedCrossRef
117.
118.
Kunin CM. A guide to the use of antibiotics in patients with renal disease. Ann Intern Med 1967; 67: 151–8PubMed
119.
Holford NH. Target concentration intervention: beyond Y2K. Br J Clin Pharmacol 1999 Jul; 48(1): 9–13PubMedCrossRef
120.
Keller F, Frankewitsch T, Zellner D, et al. Standardized structure and modular design of a pharmacokinetic database. Comput-Methods-Programs-Biomed. 1998 Feb; 55(2): 107–15PubMedCrossRef
121.
Banyai M, Thalhammer F, El-Manyawi I, et al. Pharmacokinetics of cefpirome during continuous venovenous hemofiltration: rationale for an 8-hours dosing interval. Clin Pharmacol Ther 2000 Apr; 67: 368–72PubMedCrossRef
122.
Kon SP, Kwan JT, Raftery MJ. Reversible renal failure due to the antiphospholipid antibody syndrome, pre-eclampsia and renal thrombotic microangiopathy. Clin Nephrol 1995 Oct; 44(4): 271–3PubMed
123.
Soiling J, Paulsen SM. Recurrent hemolytic uremic syndrome in a renal transplant patient during pregnancy. Scand J Urol Nephrol 1995 Dec; 29(4): 507–10CrossRef
124.
Ribeiro FM, Rocha E, Maccariello E, et al. Early gestational hemolytic uremic syndrome: case report and review of literature. Ren Fail 1997 May; 19(3): 475–9PubMedCrossRef
125.
Martinez-Roman S, Gratacos E, Torne A, et al. Successful pregnancy in a patient with hemolytic-uremic syndrome during the second trimester of pregnancy. J Reprod Med 1996 Mar; 41: 211–4PubMed
126.
Ruiz-Irastorza G, Lima F, Alves J, et al. Increased rate of lupus flare during pregnancy and the puerperium: a prospective study of 78 pregnancies. Br J Rheumatol 1996 Feb; 35(2): 133–8PubMedCrossRef
127.
Makhseed M, Raghupathy R, Azizieh F, et al. Circulating cytokines and CD30 in normal human pregnancy and recurrent spontaneous abortions. Hum Reprod 2000 Sep; 15: 2011–7PubMedCrossRef
128.
Ostensen M. Sex hormones and pregnancy in rheumatoid arthritis and systemic lupus erythematosus. Ann N Y Acad Sci 1999 Jun; 22: 131–43CrossRef
129.
Dorner T, Feist E, Pruss A, et al. Significance of autoantibodies in neonatal lupus erythematosus. Int Arch Allergy Immunol 2000 Sep; 123(1): 58–66PubMedCrossRef
130.
Azevedo LS, Romao Jr JE, Malheiros D, et al. Renal transplantation in systemic lupus erythematosus. A case control study of 45 patients. Nephrol Dial Transplant 1998 Nov; 13(11): 2894–8
131.
132.
Boletis JN, Ioannidis JP, Boki KA, et al. Intravenous immuno-globulin compared with cyclophosphamide for proliferative lupus nephritis. Lancet 1999 Aug 14; 354(9178): 569–70PubMedCrossRef
133.
Levy Y, Sherer Y, Ahmed A, et al. A study of 20 SLE patients with intravenous immunoglobulin — clinical and serologic response. Lupus 1999; 8(9): 705–12PubMedCrossRef
134.
Yu Z, Lennon VA. Mechanism of intravasous immune globuline therapy in antibody - mediated autoimmune diseases. N Engl J Med 1999; 340: 227–8PubMedCrossRef
135.
Samuelsson A, Towers TL, Ravetch JV. Anti-inflammatory activity of IVIG mediated through the inhibitory Fc receptor. Science 2001; 291: 484–6PubMedCrossRef
136.
Takeshita Y, Turumi Y, Tourna S, et al. Successful delivery in a pregnant woman with lupus anticoagulatn positive systemic lupus erythematosus treated with double filtration plasma-pheresis. Therap Apheresis 2001; 5: 22–4CrossRef
137.
Reece EA, Leguizamon G, Homko C. Pregnancy performance and outcomes associated with diabetic nephropathy. Am J Perinatol 1998 Jul; 15(7): 413–21PubMedCrossRef
138.
Piacquadio K, Hollingsworth DR, Murphy H. Effects of inutero exposure to oral hypoglycaemic drugs. Lancet 1991; 338: 866–9PubMedCrossRef
139.
Harrower AD. Pharmacokinetics of oral antihyperglycaemic agents in patients with renal insufficiency. Clin Pharmacokinet 1996 Aug: 111–119
140.
Hamai Y, Fujii T, Nishina H, et al. Differential clinical courses of pregnancies complicated by diabetes insipidus which does, or does not, pre-date the pregnancy. Hum Reprod 1997 Aug; 12(8): 1816–8PubMedCrossRef
141.
Briet JW. Diabetes insipidus, Sheehan’s syndrome and pregnancy. Eur J Obstet Gynecol Reprod Biol 1998 Apr; 77(2): 201–3PubMedCrossRef
142.
Jin-no Y, Kamiya Y, Okada M, et al. Pregnant woman with transient diabetes insipidus resistant to l-desamino-8-D-arginine vasopressin. Endocrinol J 1998 Oct; 45(5): 693–6
143.
Hanson RS, Powrie RO, Larson L. Diabetes insipidus in pregnancy: a treatable cause of oligohydramnios. Obstet Gynecol 1997 May; 89 (5 Pt 2): 816–7PubMedCrossRef
144.
Smith LG, Kirshon B, Cotton DB. Indomethacin treatment for polyhydramnios and subsequent infantile nephrogenic diabetes insipidus. Am J Obstet Gynecol 1990 Jul; 163: 98–9PubMed
145.
Ulrich M, Kristoffersen K, Rolschau J, et al. The influence of folic acid supplement on the outcome of pregnancies in the country of Funen in Demark. Part II. Congenital anomalies, a randomised study. Eur J Obstet Gynecol Reprod Biol 1999 Dec; 87(2): 111–3
146.
147.
McGowan JP, Shah SS. Reviews. Revention of perinatal HIV transmission during pregnancy. J Antimicrob Chemother 2000; 46: 657–68
148.
al-Alaiyan S, Seshia MM, Casiro OG. Neurodevelopmental outcome of infants exposed to indomethacin antenatally. J Perinatol Med 1996; 24(4): 405–11CrossRef
149.
150.
Achtari C, Hohlfeld P. Cardiotoxic transplacental effect of idarubicin administered during the second trimester of pregnancy. Am J Obstet Gynecol 2000 Aug; 183: 511–2PubMedCrossRef
151.
Salooja N, Szydlo RM, Socie G, et al. Pregnancy outcomes after peripheral blood or bone marrow transplantation: a retrospective survey. Lancet. 2001 Jul; 358(9278): 271–6PubMedCrossRef
152.
Olesen C, Steffensen FH, Nielsen GL, et al. Drug use in first pregnancy and lactation: a population-based survey among Danish women. Eur J Clin Pharmacol 1999 Apr; 55(2): 139–44PubMedCrossRef
153.
Bar-Oz B, Moretti ME, Mareels G, et al. Reporting bias in retrospective ascertainment of drug-induced embryopathy. Lancet 1999 Nov 13; 354(9191): 1700–1PubMedCrossRef
154.
McGowan JP, Crane M, Wiznia AA, et al. Combination anti-retroviral therapy in human immunodeficiency virus-infected pregnant women. Obstet Gynecol 1999 Nov; 94 (5 Pt 1): 641–6PubMedCrossRef
155.
Olyaei AJ, De Mattos AM, Bennett WM. A practical guide to the management of hypertension in renal transplant recipients. Drugs 1999; 58: 1011–27PubMedCrossRef
156.
Von Dadelszen P, Ornstein MP, Bull SB, et al. Fall in mean pressure and fetal growth restriction in pregnancy hypertension: a meta-analysis. Lancet 2000; 355: 87–92CrossRef
157.
Anonymus. Postmarketing surveillance for angiotensin-converting enzyme inhibitor use during the first trimester of pregnancy — United States, Canada, and Israel, 1987–1995. MMWR Morb Mortal Wkly Rep 1997; Mar 21; 46 (11): 240–2
158.
Satchell S, Moppett J, Quinn M, et al. Pregnancy, tacrolimus, and renal transplantation: survival of a 358-g baby [letter]. Nephrol Dial Transplant 2000; 15: 2065–6PubMedCrossRef
159.
Yunis KA, Bitar FF, Hayek P, et al. Transient hypertrophic cardiomyopathy in the newborn following multiple doses of antenatal corticosteroids. Am J Perinatol 1999 16(1): 17–21PubMedCrossRef
160.
Carmichael SL, Shaw GM. Maternal corticosteroid use and risk of selected congenital anomalies. Am J Med Genet 1999 Sep; 86(3): 242–4PubMedCrossRef
161.
Biesenbach G, Zazgornik J, Kaiser W, et al. Cyclosporin requirement during pregnancy in renal transplant recipients. Nephrol Dial Transplant 1989, 4: 667–9PubMed
162.
Smit JW, Huisman MT, van Tellingen O, et al. Absence or pharmacological blocking of placental P-glycoprotein profoundly increases fetal drug exposure. J Clin Invest 1999 Nov; 104(10): 1441–7PubMedCrossRef
163.
Lo Giudice P, Dubourg L, Hadj-Aissa A, et al. Renal function of children exposed to cyclosporin in utero. Nephrol Dial Transplant 2000; 15: 1575–9PubMedCrossRef
164.
Chan WS, Anand S, Ginsberg JS. Anticoagulation of pregnant women with mechanical heart valves: a systematic review of the literature. Arch Intern Med 2000 Jan 24; 160(2): 191–6PubMedCrossRef
165.
Crowther MA, Spitzer K, Julian J, et al. Pharmacokinetic profile of a low-molecular weight heparin (reviparin) in pregnant patients; a retrospective study. Thromb Res 2000 Apr; 98: 133–8PubMedCrossRef
166.
Meschengieser SS, Fondevila CG, Santarelli MT, et al. Anticoagulation in pregnant women with mechanical heart valve prostheses. Heart 1999 Jul; 82(1): 23–6PubMed
167.
Thorp M, Pulliam J. Use of recombinant erythropoietin in a pregnant renal transplant recipient. Am J Nephrol 1998; 18(5): 448–51PubMedCrossRef
168.
AI Shohaib S. Erythropoietin therapy in a pregnant post-renal transplant patient. Nephron 1999 Jan; 81(1): 81–3PubMedCrossRef
169.
Maruyama H, Shimada H, Obayashi H, et al. Requiring higher doses of erythropoietin suggests pregnancy in hemodialysis patients. Nephron 1998 Aug; 79(4): 413–9PubMedCrossRef
170.
Oei SG, Mol BW, deKleine JMJ, et al. Nifedipine versus ritodrine for suppression of preterm labor; a meta-analysis. Acta Obstet Gynecol Scand 1999 Oct; 78(9): 783–8PubMedCrossRef
171.
Braden GL, von Oeyen PT, Germain MJ, et al. Ritodrine- and terbutaline-induced hypokalemia in preterm labor: mechanisms and consequences. Kidney Int 1997 Jun; 51(6): 1867–75PubMedCrossRef
Metadata
Title
Pregnancy and Renal Failure
The Case for Application of Dosage Guidelines
Authors
Dr Frieder Keller
Martin Griesshammer
Ulla Häussler
Wolfgang Paulus
Anke Schwarz
Publication date
01-11-2001
Publisher
Springer International Publishing
Published in
Drugs / Issue 13/2001
Print ISSN: 0012-6667
Electronic ISSN: 1179-1950
DOI
https://doi.org/10.2165/00003495-200161130-00003

Other articles of this Issue 13/2001

Drugs 13/2001 Go to the issue

Therapy in Practice

Current Management of Primary Pulmonary Hypertension

Adis Drug Evaluation

Cyclosporin

Leading Article

Role of ACE Inhibitors in Patients with Diabetes Mellitus

Therapy in Practice

Cervical Dystonia

Current Opinion

Role of Erythromycin for Treatment of Incipient Chronic Lung Disease in Preterm Infants Colonised with Ureaplasma urealyticum