TY - JOUR
T1 - Physiology of Pregnancy-related Acute Kidney Injury
AU - Moronge, Desmond
AU - Sullivan, Jennifer C.
AU - Faulkner, Jessica L.
N1 - Publisher Copyright:
© American Physiological Society.
PY - 2023/7
Y1 - 2023/7
N2 - Renal function increases in pregnancy due to the significant hemodynamic demands of plasma volume expansion and the growing feto-placental unit. Therefore, compromised renal function increases the risk for adverse outcomes for pregnant women and their offspring. Acute kidney injury (AKI), or sudden loss of kidney function, is a significant event that requires aggressive clinical management. An AKI event in pregnancy, or in the postpartum period, significantly increases the risk of adverse pregnancy events and fetal and maternal mortality. At present, there are significant clinical challenges to the identification, diagnosis, and management of pregnancy-associated AKI due to changing hemodynamics in pregnancy that alter baseline values and to treatment limitations in pregnancy. Emerging data indicate that patients that are considered clinically recovered following AKI, which is currently assessed primarily by return of plasma creatinine levels to nor-mal, maintain risk of long-term complications indicating that current recovery criteria mask the detection of subclinical renal damage. In association, recent large-scale clinical cohorts indicate that a history of AKI predisposes women to adverse pregnancy events even years after the patient is considered recovered from AKI. Mechanisms via which women develop AKI in pregnancy, or develop adverse pregnancy events post-AKI, are poorly understood and require significant study to better prevent and treat AKI in women.
AB - Renal function increases in pregnancy due to the significant hemodynamic demands of plasma volume expansion and the growing feto-placental unit. Therefore, compromised renal function increases the risk for adverse outcomes for pregnant women and their offspring. Acute kidney injury (AKI), or sudden loss of kidney function, is a significant event that requires aggressive clinical management. An AKI event in pregnancy, or in the postpartum period, significantly increases the risk of adverse pregnancy events and fetal and maternal mortality. At present, there are significant clinical challenges to the identification, diagnosis, and management of pregnancy-associated AKI due to changing hemodynamics in pregnancy that alter baseline values and to treatment limitations in pregnancy. Emerging data indicate that patients that are considered clinically recovered following AKI, which is currently assessed primarily by return of plasma creatinine levels to nor-mal, maintain risk of long-term complications indicating that current recovery criteria mask the detection of subclinical renal damage. In association, recent large-scale clinical cohorts indicate that a history of AKI predisposes women to adverse pregnancy events even years after the patient is considered recovered from AKI. Mechanisms via which women develop AKI in pregnancy, or develop adverse pregnancy events post-AKI, are poorly understood and require significant study to better prevent and treat AKI in women.
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U2 - 10.1002/cphy.c220026
DO - 10.1002/cphy.c220026
M3 - Article
C2 - 37358509
AN - SCOPUS:85164049325
SN - 2040-4603
VL - 13
SP - 4869
EP - 4878
JO - Comprehensive Physiology
JF - Comprehensive Physiology
IS - 3
ER -