Candesartan cilexetil
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Various toxicities, including renal failure, in a fetus following in utero exposure: case report A male fetus developed acute renal failure with oligohydramnios following in utero exposure to candesartan cilexetil; other effects potentially related to in utero candesartan cilexetil exposure included growth retardation, preterm birth and patent ductus arteriosus. The boy’s mother was receiving candesartan cilexetil 4 mg/day [duration of treatment not stated] for cardiomyopathy when she discovered that she was pregnant at 22 weeks’ gestation. A fetal ultrasound revealed oedematous kidneys and reduced amniotic fluid levels. The mother discontinued candesartan cilexetil. Five weeks later, the amniotic fluid levels were normal, but the boy’s kidneys remained enlarged with hyperechogenicity. The boy was delivered prematurely at 31 weeks’ gestation, with a birthweight of 2209g; his creatinine level and creatinine clearance were normal the following day. Renal ultrasonography at weeks 1 and 2 revealed marked calices, small cysts and increased parenchymal echogenicity bilaterally. By week 6, his ultrasound findings had normalised. He also had a systolic murmur secondary to patent ductus arteriosus. Author comment: In utero candesartan exposure during the first 22 weeks of pregnancy led to "acute kidney failure with oligohydramnios, which was reversible after withdrawal of Candesartan. Other potential complications were intrauterine growth retardation, premature labour and a [patent ductus arteriosus]". Munk PS, et al. Reversible fetal renal failure after maternal treatment with Candesartan: A case report. Reproductive Toxicology 29: 381-382, No. 3, Jun 2010. Available from: URL: http://dx.doi.org/10.1016/j.reprotox.2010.01.010 803020382 Norway
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Reactions 19 Jun 2010 No. 1306
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