Acute proliferative glomerulonephritis with crescents and renal failure in pregnancy successfully managed by intermittent haemodialysis. Case report.

A 26-year-old patient with no previous history of renal disease developed acute non-streptococcal crescentile glomerulonephritis with severe renal failure in the 17th week of her second pregnancy. It became necessary to treat her with haemodialysis to maintain the blood urea around 25 mmol/l. The haemoglobin was maintained above 9 g/dl with regular blood transfusion and the blood pressure was controlled with hypotensive drugs. Measurement of fetal biparietal diameter and human placental lactogen indicated normal fetal growth and placental function. The patient spontaneously delivered a healthy infant at 32 weeks. Haemodialysis requirements decreased post partum and the patient even managed without dialysis for 12 weeks. Renal function, however, remained severely impaired and maintenance haemodilysis was again necessary at nine months post partum. Glomerulonephritis complicating pregnancy is reviewed and the management of acute and chronic renal failure in pregnancy is discussed.