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Review
. 2019 Sep 6;8(9):1396.
doi: 10.3390/jcm8091396.

The Changing Landscape of Acute Kidney Injury in Pregnancy from an Obstetrics Perspective

Angela Vinturache  1 , Joyce Popoola  2   3 , Ingrid Watt-Coote  2
Affiliations
Review

The Changing Landscape of Acute Kidney Injury in Pregnancy from an Obstetrics Perspective

Angela Vinturache et al. J Clin Med. .

Abstract

Pregnancy-related acute kidney injury (PR-AKI) is a heterogeneous disorder with multiple aetiologies that can occur at any time throughout pregnancy and the post-partum period. PR-AKI is an important obstetric complication that is associated with significant maternal and foetal morbidity and mortality. Although there has been an overall decline in the incidence of PR-AKI worldwide, a recent shift in the occurrence of this disease has been reported. Following improvements in obstetric care, PR-AKI incidence has been reduced in developing countries, whereas an increase in PR-AKI incidence has been reported in developed countries. Awareness of the physiological adaptations of the renal system is essential for the diagnosis and management of kidney impairment in pregnancy. In this review we scrutinize the factors that have contributed to the changing epidemiology of PR-AKI and discuss challenges in the diagnosis and management of acute kidney injury (AKI) in pregnancy from an obstetrics perspective. Thereafter we provide brief discussions on the diagnostic approach of certain PR-AKI aetiologies and summarize key therapeutic measures.

Keywords: acute kidney injury; kidney; physiology of pregnancy; pregnancy; pregnancy-related acute kidney injury.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Renal adaptation to pregnancy. Abbreviations: GFR, glomerular filtration rate; RVR, renal vascular resistance; RBF, renal blood flow; RPF, renal plasma flow; FF, filtration fraction; RAAS, renin-angiotensin system; AT1R, angiotension type 1 receptors.
Figure 2
Figure 2
Common causes of pregnancy-related (PR)-AKI classified by a physiopathological mechanism of kidney injury.
See this image and copyright information in PMC

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