Acute kidney injury in pregnancy

Abstract

Any kind of acute renal deterioration that occurs in young women may, besides typical pregnancy-related disorders, account for pregnancy-related acute kidney injury (PR-AKI). Incidence of PR-AKI is continuously decreasing, yet still represents a significant cause of fetomaternal morbidity and mortality. Hyperemesis gravidarum causing volume depletion and septic shock with renal cortical necrosis upon septic abortion are major causes of PR-AKI during early pregnancy. Pre-eclampsia and bleeding complications associated with placental abruption or other causes of obstetric haemorrhage are responsible for the majority of cases during late pregnancy (after week 35) and puerperium. Haemolytic uraemic syndrome and thrombotic thrombocytopenic purpura disorders are less common than pre-eclampsia, yet represent a diagnostic and therapeutic challenge due to similar features to severe pre-eclampsia cases.