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September 1971

Effect of Bilateral Nephrectomy in Postpartum Nephrosclerosis

Author Affiliations

San Francisco

From the medical, the clinical pathology, and laboratory medicine services, San Francisco General Hospital and the departments of medicine and clinical pathology and laboratory medicine, University of California School of Medicine, San Francisco.

Arch Intern Med. 1971;128(3):448-452. doi:10.1001/archinte.1971.00310210124016

Several recent reports have called attention to a newly recognized syndrome of irreversible postpartum renal failure and microangiopathic hemolytic anemia that develops following normal pregnancy.1-6 The cause of renal failure and its relationship to the accompanying hemolysis remain unknown. A patient with this syndrome eventually required bilateral nephrectomy for control of malignant hypertension. The pathologic findings and postoperative course in this case suggest that the renal abnormalities may play a prominent role in the production of the fragmented red blood cells and hemolysis observed in this syndrome.

Patient Summary  A 20-year-old woman in the eighth month of her first pregnancy was hospitalized in December 1968, for evaluation of proteinuria. Mild proteinuria, ankle edema, and a hematocrit value of 30% were first noted in August 1968, during her first trimester of pregnancy. Blood pressure at that time was 110/70 mm Hg. Treatment with a low sodium diet, vitamins, oral diuretics,

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