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Approach to AKI in Pregnancy

Acute kidney damage (AKI) in pregnancy is a major contributor to morbidity and mortality in both the mother and the fetus. Preeclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, acute fatty liver disease of pregnancy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome are among the complications that can lead to pregnancy-related acute kidney injury (AKI) later in the pregnancy. Hyperemesis gravidarum is a common cause of pregnancy-related AKI during the first trimester. A kidney biopsy should be explored when the laboratory evaluation for AKI is non-diagnostic, as a definitive diagnosis will aid to facilitate proper therapy, outweighing the hazards of biopsy. Diagnosis of pregnancy-related AKI is difficult because there are no established diagnostic criteria. Finding the underlying cause of kidney damage and administering intravenous fluid are general treatments for acute kidney injury (AKI) during pregnancy.

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Dr. Shrikant Sahasrabudhe Profile Image

Dr. Shrikant Sahasrabudhe

Head of the Department, Critical Care & Pulmonology, KIMS Manavata Hospital, Nashik

Dr. Shrikant Sahasrabudhe, Head of the Department, Critical Care & Pulmonology, KIMS Manavata Hospital, Nashik

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Acute kidney damage (AKI) in pregnancy is a major contributor to morbidity and mortality in both the mother and the fetus. Preeclampsia, hemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome, acute fatty liver disease of pregnancy, thrombotic thrombocytopenic purpura, and hemolytic uremic syndrome are among the complications that can lead to pregnancy-related acute kidney injury (AKI) later in the pregnancy. Hyperemesis gravidarum is a common cause of pregnancy-related AKI during the first trimester. A kidney biopsy should be explored when the laboratory evaluation for AKI is non-diagnostic, as a definitive diagnosis will aid to facilitate proper therapy, outweighing the hazards of biopsy. Diagnosis of pregnancy-related AKI is difficult because there are no established diagnostic criteria. Finding the underlying cause of kidney damage and administering intravenous fluid are general treatments for acute kidney injury (AKI) during pregnancy.