Renal Failure in Pregnancy

Crit Care Clin. 2016 Jan;32(1):73-83. doi: 10.1016/j.ccc.2015.08.003. Epub 2015 Oct 9.


Renal failure during pregnancy affects both mother and fetus, and may be related to preexisting disease or develop secondary to diseases of pregnancy. Causes include hypovolemia, sepsis, shock, preeclampsia, thrombotic microangiopathies, and renal obstruction. Treatment focuses on supportive measures, while pharmacologic treatment is viewed as second-line therapy, and is more useful in mitigating harmful effects than treating the underlying cause. When supportive measures and pharmacotherapy prove inadequate, dialysis may be required, with the goal being to prolong pregnancy until delivery is feasible. Outcomes and recommendations depend primarily on the underlying cause.

Keywords: Acute fatty liver of pregnancy; Dialysis; HELLP; Preeclampsia; Pregnancy; Renal failure; Thrombotic microangiopathies.

Publication types

  • Review

MeSH terms

  • Acute Kidney Injury* / complications
  • Acute Kidney Injury* / epidemiology
  • Acute Kidney Injury* / etiology
  • Acute Kidney Injury* / therapy
  • Female
  • Humans
  • Kidney Failure, Chronic* / complications
  • Kidney Failure, Chronic* / epidemiology
  • Kidney Failure, Chronic* / etiology
  • Kidney Failure, Chronic* / therapy
  • Pregnancy
  • Pregnancy Complications* / epidemiology
  • Pregnancy Complications* / etiology
  • Pregnancy Complications* / therapy
  • Renal Replacement Therapy / methods*
  • Renal Replacement Therapy / standards
  • Urologic Surgical Procedures / methods*
  • Urologic Surgical Procedures / standards