Acute renal failure as a complication of hypertonic saline abortion in a kidney allograft recipient

Acute renal failure following abortion by intra-amniotic hypertonic saline administration has been described only occasionally. This report concerns a patient with end-stage renal failure who was successfully treated with a kidney allograft and developed reversible acute renal failure following the termination of her pregnancy by intra-amniotic infusion of saline. We suspect that the combination of hemoglobinuria and low grade intravascular coagulation might have been a contributing factor in the development of renal insufficiency in this patient. To our knowledge this modality of abortion has not been used previously in pregnant women with transplanted kidneys. From our experience with one patient it seems wise to express a word of caution on the use of this technique in patients with a functioning kidney allograft.