Challenges in Diagnosis and Treatment of Acute Kidney Injury During Pregnancy

Pregnant women with acute kidney injury (AKI) represent a unique challenge for health care providers. In approaching AKI in pregnant women, emphasis should be placed on making an early and accurate diagnosis to allow prompt intervention and to facilitate recovery from AKI. In this article, I review the prevalence of AKI in pregnancy and the impact it has on morbidity and mortality. I then review diagnostic criteria and discuss fetal monitoring methods. The utility of various renal replacement methods available for pregnant women with AKI is discussed, as well as the specific adjustments to hemodialysis prescriptions for pregnant women. This review summarizes the existing data on the management of AKI during pregnancy, however, most of these studies were observational. Future research with longitudinal study designs are needed to allow examination of the effect of AKI during pregnancy on adverse maternal and fetal outcomes.