Pregnancy-associated acute kidney injury - consensus report of the 32nd Acute Disease Quality Initiative workgroup.
Journal
Nature reviews. Nephrology
Journal Volume
21
Journal Issue
9
Start Page
633
End Page
646
ISSN
1759-507X
Date Issued
2025-09
Author(s)
Nelson-Piercy, Cathy
Srisawat, Nattachai
Kashani, Kianoush
Lumlertgul, Nuttha
Murugan, Raghavan
Rhee, Harin
Chakravarthi, Raj
Surapaneni, Tarakeswari
Acharya, Anjali
Ankawi, Ghada
Bramham, Kate
Cerda, Jorge
Clark, Katherine
Claure-Del Granado, Rolando
Gowrishankar, Swarnalata
Luyckx, Valerie
Menon, Shina
Poli-de-Figueiredo, Carlos E
Ramachandran, Raja
Sahay, Manisha
Samavedam, Srinivas
Shemies, Rasha
Shetty, Manjunath S
Wiles, Kate
Wium, Lizemarie
Yadla, Manjusha
Ronco, Claudio
Mehta, Ravindra L
Ostermann, Marlies
Abstract
Acute kidney injury (AKI) during pregnancy and the postpartum period, known as pregnancy-associated AKI (PrAKI), is an important health concern and driver of health inequity worldwide. Causes of PrAKI include sepsis, autoimmune disorders and pregnancy-specific pathologies such as hypertensive disorders. Common risk factors include maternal comorbidities and use of nephrotoxic medications. PrAKI accounts for a substantial proportion of maternal mortality and morbidity, particularly in low-income and middle-income countries, and may also adversely affect the fetus, resulting in death, premature birth and small for gestational age. In this Consensus Statement, we present recommendations on the causes, diagnosis, management and follow-up of PrAKI from the 32nd Acute Disease Quality Initiative meeting, which involved international experts in obstetrics, midwifery, obstetric medicine, paediatrics, internal medicine, anaesthesiology, nephrology and critical care. We suggest that pregnant and postpartum women at a high risk of PrAKI should be identified to enable prevention, surveillance and timely diagnosis. The multidisciplinary management of these patients should be tailored to treat their specific causes of PrAKI to optimize short-term and long-term neonatal and maternal outcomes. Further observational and interventional studies are needed to address existing gaps in knowledge of PrAKI and improve maternal and fetal outcomes.
Type
journal article