Why kidneys fail post-partum: a tubulocentric viewpoint

  • Patricia Villie
  • Marc Dommergues
  • Isabelle Brocheriou
  • Giorgina Barbara Piccoli
  • Jérôme Tourret
  • Alexandre Hertig
Part of the following topical collections:
  1. Obstetric Nephrology


Kidneys may fail post-partum in a number of circumstances due, for example, to post-partum haemorrhage, preeclampsia, amniotic fluid embolism or septic abortion. All these conditions in pregnancy and post partum represent a threat not only to the endothelium but also to the renal tubular epithelium, and as such may lead to rapid and also irreversible impairment of the renal function. This paper is a non-systematic review of the literature and of our experience, in which we discuss the main open issues on kidney disease in pregnancy and following delivery, in particular as regards tubular damage, with the aim to help reasoning on acute kidney injury (AKI) following delivery. The review will emphasize the often under-estimated importance of the tubular epithelium in the peri-partum period and will: (1) describe the main characteristics of the renal tissues around delivery; (2) define pregnancy-related AKI according to recent Kidney Disease/Improving Global Outcome (KDIGO) guidelines; (3) discuss the most common circumstances of post-partum AKI; and (4) describe the input expected from urinalysis, renal imaging and kidney biopsy.


Acute kidney injury Acute tubular necrosis Pregnancy Preeclampsia Post-partum haemorrhage sFlt-1 PlGF 



Acute kidney injury


Acute tubular necrosis


Retinol-binding protein


Soluble endoglin


Soluble fms-like tyrosine kinase 1


Thrombotic microangiopathy


Vascular endothelial growth factor



This work received no financial support.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

For this type of study formal consent is not required.


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Copyright information

© Italian Society of Nephrology 2018

Authors and Affiliations

  1. 1.APHP, Hôpital TenonUrgences Néphrologiques et Transplantation RénaleParisFrance
  2. 2.Department of Gynecology and ObstetricsAPHP, Groupe Hospitalier La Pitié Salpêtrière Charles FoixParisFrance
  3. 3.Department of PathologyAPHP, Hôpital TenonParisFrance
  4. 4.Sorbonne Universités, UPMC Université Paris 06, UMR_S 1155ParisFrance
  5. 5.Centre Hospitalier du Mans Le MansLe MansFrance
  6. 6.Department of Clinical and Biological SciencesUniversity of TorinoTurinItaly

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