enalapril and Anuria

Neonatal anuria is not an uncommon problem in neonates. Here, we report an unusual case of neonatal anuria due to renal tubular dysgenesis, secondary to the use of angiotensin converting enzyme inhibitor (ACEI) during pregnancy. ACEI remains one of the most commonly used antihypertensive drug at present. A greater awareness needs to be created in the medical fraternity especially among pediatricians, gynecologists and internists that ACE inhibitors should not be prescribed during any trimester of pregnancy.

Topics: Adult; Angiotensin-Converting Enzyme Inhibitors; Anuria; Enalapril; Female; Humans; Infant, Newborn; Male; Pregnancy; Prenatal Exposure Delayed Effects

Successful bilateral renal revascularization was performed 24 days after the development of angiotensin converting enzyme-inhibitor-induced bilateral renal artery thrombosis and anuric acute renal failure in a patient with Takayasu's arteritis. Excellent results were obtained after an unusually long ischemic time for a patient with active-phase disease. The outcome suggests that aggressive surgical revascularization can benefit patients with renal failure caused by renal arterial occlusion during the active phase of Takayasu's arteritis.

Topics: Acute Kidney Injury; Adult; Angiotensin-Converting Enzyme Inhibitors; Anuria; Collateral Circulation; Enalapril; Female; Humans; Radiography; Renal Artery Obstruction; Takayasu Arteritis; Thrombosis

Topics: Acute Kidney Injury; Adult; Angiotensin-Converting Enzyme Inhibitors; Anuria; Cesarean Section; Enalapril; Female; Humans; Hypertension; Infant, Newborn; Iodine Radioisotopes; Kidney; Peptidyl-Dipeptidase A; Peritoneal Dialysis; Pregnancy; Pregnancy Complications, Cardiovascular; Pregnancy Trimester, Third; Prenatal Exposure Delayed Effects; Radionuclide Imaging; Technetium Tc 99m Pentetate

Topics: Administration, Oral; Angiotensin II; Angiotensin-Converting Enzyme Inhibitors; Anuria; Drug Overdose; Enalapril; Female; Humans; Hypotension; Infusions, Intravenous; Middle Aged

Persistent anuria was diagnosed in a neonate born to a mother whose pregnancy was complicated by severe hypertension and systemic lupus erythematosus. Severe maternal hypertension necessitated the use of a battery of antihypertensive medications that included enalapril, an angiotensin converting enzyme inhibitor. The role of enalapril in neonatal renal failure is discussed.

Topics: Acute Kidney Injury; Antihypertensive Agents; Anuria; Drug Therapy, Combination; Enalapril; Female; Humans; Hyaline Membrane Disease; Hypertension; Infant, Newborn; Kidney; Lupus Erythematosus, Systemic; Male; Pregnancy; Pregnancy Complications

Angiotensin converting-enzyme inhibitors cross the placenta and modify the maternal, foetal and utero-placental renin-angiotensin system. Eight cases of pregnancy in women taking captopril have been published, 7 other cases being reported in this review paper. There were one spontaneous and 2 therapeutic abortions, one of which disclosed a malformation of uncertain diagnosis and imputation. One intrauterine death at 28 weeks was probably due to the severity of the maternal disease. Two children born to mothers also treated with frusemide died of neonatal anuria. Delivery or caesarean section occurred before term in 8 cases, and there were 3 cases of neonatal respiratory distress with a favourable outcome. Finally, one mother gave birth at term to twins of normal weight. The cases with respiratory distress can be attributed to the mother's hypertension, to prematurity and/or to concomitant treatment with beta-blockers, while the cases with anuria seem to be due to inhibition of the effects of angiotensin on renal haemodynamics, with salt depression as a possible aggravating factor. Treatment with angiotensin converting enzyme inhibitors does not seem to warrant therapeutic abortion. However, these drugs are contra-indicated in pregnancy and should only be given to women wishing to become pregnant if they present with resistant and dangerous arterial hypertension. A programme of pharmacovigilance is being set up to follow up such pregnancies.

Topics: Abortion, Spontaneous; Anuria; Captopril; Enalapril; Female; Fetal Diseases; Humans; Hypertension; Infant, Newborn; Pregnancy; Pregnancy Complications, Cardiovascular; Prenatal Exposure Delayed Effects; Product Surveillance, Postmarketing; Renin-Angiotensin System; Respiratory Insufficiency