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The physiologic changes in the kidney pose a challenge to the diagnosis of acute kidney injury in pregnancy.
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Assessment of baseline renal function and proteinuria early in prenatal care is essential for accurate diagnosis of pregnancy-related acute kidney injury.
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Identification of women at risk for acute kidney injury plays a crucial role in prompt diagnosis and prevention of acute kidney injury.
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Optimal management of women with pregnancy-related acute kidney injury requires a multidisciplinary
Management of Acute Kidney Injury in Pregnancy for the Obstetrician
Section snippets
Key points
Background
The incidence of pregnancy-related acute kidney injury (PR-AKI) varies widely across the world, with reported incidence of 1 in 20,000 pregnancies1 to as much as 1 in 50 pregnancies.2 Many factors contribute to this variation in incidence, such as lack of uniform defining criteria, physiologic changes in pregnancy that affect interpretation of laboratory tests, and regional differences in factors contributing to acute kidney injury (AKI). In addition, AKI (a term that has replaced acute renal
Summary
In all, the incidence of P-AKI has probably decreased, but its fetal and maternal morbidity remain unacceptably high.
Pregnancy hypertensive complications, notably HELLP syndrome, are the leading cause of P-AKI.
P-TMA is a clinically challenging cause of P-AKI.
Several breakthroughs in our understanding of different mechanisms underlying P-TMA and preeclampsia have already led to a better treatment of these patients.
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2018, NefrologiaCitation Excerpt :PE and hypertensive disorders of pregnancy occur in 3–10% of all pregnancies2,18; in these disorders the kidney is the main target of an unbalanced pro-angiogenic and anti-angiogenic derangement, leading to hypertension, proteinuria, and widespread endothelial damage. The incidence of PE, higher in low-middle income countries (possibly reflecting undiagnosed predisposing diseases), peaks at the extremes of reproductive age for reasons mentioned above.12,20–22 The relationship between kidney and placenta is biunivocal, and the presence of CKD is a risk factor for PE and hypertensive disorders of pregnancy (Fig. 2).
Hesperidin improves physiological outcomes in an arginine vasopressin rat model of pre-eclampsia
2024, Fundamental and Clinical PharmacologyUrinary congophilia in pregnancy: a marker of kidney injury rather than preeclampsia
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2023, Journal of Clinical Medicine
The author has no financial conflict.