Acute Kidney Injury in Pregnancy

Abstract

Pregnancy related Acute Kidney Injury (AKI) is a usual clinical challenge involving two patients. The incidence has declined over the last decades, however, peripartum AKI remains associated with substantial maternal and fetal morbidity and mortality. Physiological changes hamper normal laboratory testing. Timing of onset during the pregnancy may help in diagnosing the syndrome causing AKI: during the first trimester causes include hyperemesis gravidarum or hemorrhage. Later in pregnancy AKI is predominantly caused by preeclampsia/HELLP, thrombotic microangiopathies, acute fatty liver of pregnancy, and renal cortical necrosis related to infection, urinary tract obstruction, or nephrolithiasis. Care for pregnant women with AKI requires a multidisciplinary approach due to its association with higher risk for maternal and fetal morbidity and mortality.