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Kidney injury during pregnancy: associated comorbid conditions and outcomes

  • Maternal-Fetal Medicine
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To investigate the characteristics of women who have kidney injury during pregnancy.

Methods

Medical records of all women who gave birth at our institution between January 1, 2005, and December 31, 2010, were retrospectively reviewed electronically. We identified those who incurred a kidney injury [defined by modified Acute Kidney Injury Network (AKIN) criteria: serum creatinine (sCr) increase ≥0.3 mg/dL] during pregnancy or within 30 days postpartum. Identified case records were reviewed in detail.

Results

During the study period, 54 women had a kidney injury (0.4 % estimated incidence) with a mean (SD) increase in sCr of 0.46 (0.29) mg/dL; most injuries were AKIN stage 1 with transient increases in sCr. Most of the women (n = 48, 87.3 %) had substantial preexisting or pregnancy-associated comorbid conditions (e.g., kidney disease, hypertension, diabetes), complications (e.g., preeclampsia, HELLP syndrome), or a complicated obstetric course (hemorrhage, infections) that could have contributed to the development of a kidney injury. Two patients had AKIN stage 3 injuries: a previously healthy patient who had a massive hemorrhage during cesarean delivery, and a patient with a renal transplant who had deterioration and eventual postpartum failure of her transplanted kidney.

Conclusions

The majority of pregnancy-associated kidney injuries were transient and occurred in women with substantial comorbid conditions or complicated pregnancies.

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Abbreviations

AKIN:

Acute kidney injury network

KI:

Kidney injury

PKD:

Polycystic kidney disease

sCr:

Serum creatinine

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Acknowledgments

This project was supported by NIH/NCRR CTSA Grant Numbers UL1 RR-024150 and KL2 RR-024151. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.

Conflict of interest

We declare that we have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN, 55905, USA

    Carmelina Gurrieri, Juraj Sprung, Bradly J. Narr & Toby N. Weingarten

  2. Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA

    Vesna D. Garovic

  3. Department of Anesthesia and Intensive Care, Policlinico University Hospital, Catania, Italy

    Antonino Gullo

  4. Department of Gynecology and Obstetrics, University of Zagreb Medical School, University Hospital Centre Zagreb, Zagreb, Croatia

    Katarina Bojanić

Authors
  1. Carmelina Gurrieri
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  2. Vesna D. Garovic
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Correspondence to Toby N. Weingarten.

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Gurrieri, C., Garovic, V.D., Gullo, A. et al. Kidney injury during pregnancy: associated comorbid conditions and outcomes. Arch Gynecol Obstet 286, 567–573 (2012). https://doi.org/10.1007/s00404-012-2323-5

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  • DOI: https://doi.org/10.1007/s00404-012-2323-5

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