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01.11.2001 | Review Article

Pregnancy and Renal Failure

The Case for Application of Dosage Guidelines

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

Erschienen in: Drugs | Ausgabe 13/2001

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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.

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Titel: Pregnancy and Renal Failure
The Case for Application of Dosage Guidelines
verfasst von: Dr Frieder Keller
Martin Griesshammer
Ulla Häussler
Wolfgang Paulus
Anke Schwarz
Publikationsdatum: 01.11.2001
Verlag: Springer International Publishing
Erschienen in: Drugs / Ausgabe 13/2001
Print ISSN: 0012-6667
Elektronische ISSN: 1179-1950
DOI: https://doi.org/10.2165/00003495-200161130-00003

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Pregnancy and Renal Failure

The Case for Application of Dosage Guidelines

Abstract

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

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