Postnatal acute renal failure after fetal exposure to angiotensin receptor blockers

Marchetto, Luca; Sordino, Desirée; Bernardo, Giuseppe De; Trevisanuto, Daniele

doi:10.1136/bcr-2014-207450

Cited by 7 publications

(8 citation statements)

References 20 publications

(17 reference statements)

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“…Same is probably true for telmisartan. According to the current literature telmisartan has fetal toxic effects with neonatal acute renal failure and/or renal impairment [77,78]. Yet there is no information available on placental permeability of telmisartan in humans.…”

Section: Discussionmentioning

confidence: 99%

Detection of drugs in paired maternal and umbilical cord blood samples

Veit¹,

Erdmann²,

Birngruber³

et al. 2017

RJLM

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Objectives. The consumption of drugs during pregnancy or delivery leads to pre and intranatal drug exposure of the fetus. The purpose of this study was to examine paired blood samples of the mother and the umbilical cord regarding drug distribution. Methods. Over a period of two years, 22 pregnant women with known or admitted drug use were selected. Paired blood samples of the mothers and the umbilical cord blood were collected shortly before and during birth/caesarean section, respectively. The samples were subjected to systematic immunochemical, HPLC-DAD, GC/MS and LC-MS/MS analysis and compared regarding presence of drugs. Results. Methadone, THC-COOH, tramadol, benzoylecgonine, citalopram, carbamazepine, lamotrigine, perazine, methylphenidate, quetiapine, ranitidine and most constituents of spinal and epidural anaesthesia were found in both, maternal and umbilical cord blood samples. THC, 11-OH-THC, olanzapine, diphenhydramine and telmisartan were found in maternal blood only. Conclusions. As previously shown a variety of drugs is able to pass the placenta of pregnant woman. Umbilical cord blood appears to be a viable matrix for the detection of maternal drug consumption. Drugs administered during labour and birth could be detected in umbilical cord blood. Further studies with a greater collective of women with known drug use including analyses of fetal/infant samples will yield additional information in the future.

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Section: Discussionmentioning

confidence: 99%

Detection of drugs in paired maternal and umbilical cord blood samples

Veit¹,

Erdmann²,

Birngruber³

et al. 2017

RJLM

View full text Add to dashboard Cite

show abstract

“…The levels of phosphorus (P), iPTH, alkaline phosphatase (ALP), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL- Hui Zheng and Zhinan Liu bolic disorders and increase the disability rate or mortality rate of patients (8)(9)(10). Chronic kidney disease has many side effects, and hyperphosphatemia is one of the most common side effects, due to decreased glomerular filtration rate (GFR).…”

Section: Observational Indexesmentioning

confidence: 99%

Effect of calcitriol combined with sevelamer carbonate on serum parathyroid hormone in patients with chronic renal failure

Zheng

Liu

2020

Cell Mol Biol (Noisy-le-grand)

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This study aimed to observe and analyze the effect of calcitriol combined with sevelamer carbonate on serum parathyroid hormone in patients with chronic renal failure. This study included 180 patients who had been treated for chronic renal failure in our hospital were enrolled as research objects. The patients were randomly divided into two groups: a research group and a control group, each containing 90 cases. The research group was treated with calcitriol combined with sevelamer carbonate, and the control group was treated with calcitriol alone. The therapeutic effects of the two groups were observed and analyzed by SPSS 21. Comparing the levels of blood indexes (Ca, Cr, P, ALP, iPTH, TC, TG, LDL-C, HDL-C) of the two groups showed no significant difference between the two groups, P <0.05. Our results have the effect of different treatment regimens, the improvement effect of various blood indicators in the research group was significantly better than the control group, p<0.05. We concluded that the combined therapy of calcitriol and sevelamer carbonate in chronic renal failure patients can significantly improve the therapeutic effect, and at the same time actively improve the serum parathyroid hormone level, which is a treatment model that can be popularized and applied.

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“…[10][11][12][13] Such association did not change after taking potential confounders into account, including treatment duration, concomitant drug use, concurrent disease and maternal age in a large published series of 110 infants. 14 Exposure to ARB beyond the first trimester of pregnancy appears to be associated with a higher risk for adverse fetal outcomes, 15 with similar phenotypic features as ACEi exposure [16][17][18][19][20] and possible inferior vena cava thrombosis. 21 ARB exposure may have a worse outcome compared with ACEi.…”

Section: Introductionmentioning

confidence: 99%

“…23,24 Survivors may have chronic kidney disease and end stage kidney disease in early childhood or complications related to severe retinopathy of prematurity among those born prematurely. 16,25,26 Renal histopathology of autosomal recessive tubular dysgenesis is described as having normal nephrogenic zones with hypoplastic undifferentiated cells in the cortex with lack of the proximal convoluted tubule (PCT) immunophenotype. 27 These microscopic findings are similar to those described in ACEi/ARB (AA) exposure during pregnancy, which is characterized as a reduction in PCT by both routine light microscopy and anti-CD10 immunohistochemistry (IHC) 28 ; however, this reduction has yet to be quantified in a standardized manner.…”

Section: Introductionmentioning

confidence: 99%

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Quantifying Proximal Collecting Tubule Deficiency in Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Fetopathy

et al. 2021

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Introduction Angiotensin-Converting Enzyme Inhibitors and Angiotensin II Receptor Blockers (AAs) are used for several indications, with cessation recommended in pregnancy due to toxic effects. AA fetopathy phenotype is similar to renal tubular dysgenesis including reduced proximal convoluted tubules (PCTs). Our study aimed to quantify the reduction of PCTs in fetuses and infants with prenatal exposure to AAs. Materials and methods We identified 5 fetal AA exposure cases that underwent autopsy at our institution between 2011 and 2018 and compared with 5 gestational age-matched controls. Immunohistochemistry with CD10 and epithelial membrane antigen (EMA) was utilized. Results CD10 and EMA identified a median PCT density of 19.0% ± 12.3% in AA fetopathy patients, significantly less than controls (52.8% ± 4.4%; p < 0.0001). One case with in utero cessation had a PCT density of 34.2% ± 0.2%. Among other AA fetopathy findings, 1 case demonstrated unilateral renal vein thrombosis and 4 had hypocalvaria. Conclusions We have quantified the reduction in AA fetopathy PCT density, and demonstrated in utero cessation may recover PCT differentiation. Future studies may benefit from calculating PCT percentage as a potential biomarker to correlate with post-natal renal function and maternal factors including medication type, dosage, duration, and time from medication cessation.

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Postnatal acute renal failure after fetal exposure to angiotensin receptor blockers

Cited by 7 publications

References 20 publications

Detection of drugs in paired maternal and umbilical cord blood samples

Detection of drugs in paired maternal and umbilical cord blood samples

Effect of calcitriol combined with sevelamer carbonate on serum parathyroid hormone in patients with chronic renal failure

Quantifying Proximal Collecting Tubule Deficiency in Angiotensin-Converting Enzyme Inhibitor and Angiotensin II Receptor Blocker Fetopathy

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