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October 17, 1966

Postpartum Acute Renal Failure

JAMA. 1966;198(3):50. doi:10.1001/jama.1966.03110160024013

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What may be a previously undescribed condition—acute renal failure of delayed onset in normotensive, postpartum women— has been reported.

Although acute renal failure in the immediate postpartum period is not unusual, in the three patients that comprised this report, onset was delayed one to three weeks, occurred in the absence of any apparent precipitating factors, and was marked histologically by acute, necrotizing lesions of interlobular arteries and afferent arterioles.

While the renal lesions were similar to those found in malignant hypertension, their occurrence in normotensive, postpartum women has not been previously described, reported Richard D. Wagoner, MD; Keith E. Holley, MD; and William J. Johnson, MD, the Mayo Clinic, Rochester, Minn.

"We have no explanation for the pathogenesis of these lesions," said Dr. Wagoner, "but there appears to be some relationship to pregnancy, since we have not seen this in other cases of acute renal failure in the absence of