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Review

Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases

1
Department of Clinical and Biological Sciences, University of Torino, 10100 Torino, Italy
2
Néphrologie, Centre Hospitalier Le Mans, 72000 Le Mans, France
3
Nephrology, Moscow City Hospital n.a. S.P. Botkin, 101000 Moscow, Russia
4
Nephrology, Moscow State University of Medicine and Dentistry, 101000 Moscow, Russia
5
Nephrology, Russian Medical Academy of Continuous Professional Education, 101000 Moscow, Russia
6
Obstetrics, Department of Surgery, University of Torino, 10100 Torino, Italy
7
Nephrology Service, Hospital Civil de Guadalajara “Fray Antonio Alcalde”, University of Guadalajara Health Sciences Center, 44100 Guadalajara Jal, Mexico
8
Department of Medicine, Dubai Medical College, P.O. Box 20170, Dubai, UAE
9
National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210000, China
10
Yaounde General Hospital & Faculty of Medicine and Biomedical Sciences, University of Yaounde I, P.O. Box 337, Yaounde, Cameroon
11
Instituto Nacional de Perinatologia, Mexico D.F. 01020, Mexico
12
Nefrologia Ospedale Botzu, 09100 Cagliari, Italy
13
Prince of Wales Hospital, Department of Medicine and Therapeutics, Chinese University of Hong Kong, Hong Kong
14
Department of Medicine, Division of Nephrology, University of British Columbia, Vancouver, BC V6T 1Z4, Canada
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2018, 7(10), 318; https://doi.org/10.3390/jcm7100318
Received: 17 August 2018 / Revised: 18 September 2018 / Accepted: 19 September 2018 / Published: 1 October 2018
Pregnancy-related acute kidney injury (pAKI), preeclampsia (PE), and the hypertensive disorders of pregnancy are closely related conditions, which are, in turn, frequently linked to pre-existing and often non-diagnosed chronic kidney disease (CKD). The current literature and research mainly underline the effects of pregnancy complications on the offspring; this review strongly emphasizes the maternal health as well. These conditions not only negatively affect pregnancy outcomes, but have a relevant effect on the future health of affected mothers and their children. Therefore, dedicated diagnostic and follow-up programs are needed, for optimizing materno-foetal health and reducing the impact of pregnancy-related problems in the mothers and in the new generations. This narrative review, performed on the occasion of the 2018 World Kidney Day dedicated to women’s health, focuses on three aspects of the problem. Firstly, the risk of AKI in the hypertensive disorders of pregnancy (the risk is the highest in developing countries; however PE is the main cause of pregnancy related AKI worldwide). Secondly, the effect of AKI and the hypertensive disorders of pregnancy on the development of CKD in the mother and offspring: long-term risks are increased; the entity and the trajectories are still unknown. Thirdly, the role of CKD in the pathogenesis of AKI and the hypertensive disorders of pregnancy: CKD is a major risk factor and the most important element in the differential diagnosis; pregnancy is a precious occasion for early diagnosis of CKD. Higher awareness on the importance of AKI in pregnancy is needed to improve short and long term outcomes in mothers and children. View Full-Text
Keywords: pregnancy acute kidney injury (AKI); chronic kidney disease (CKD); preeclampsia; maternal death; adverse pregnancy outcomes pregnancy acute kidney injury (AKI); chronic kidney disease (CKD); preeclampsia; maternal death; adverse pregnancy outcomes
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MDPI and ACS Style

Piccoli, G.B.; Zakharova, E.; Attini, R.; Ibarra Hernandez, M.; Covella, B.; Alrukhaimi, M.; Liu, Z.-H.; Ashuntantang, G.; Orozco Guillen, A.; Cabiddu, G.; Li, P.K.T.; Garcia-Garcia, G.; Levin, A. Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases. J. Clin. Med. 2018, 7, 318. https://doi.org/10.3390/jcm7100318

AMA Style

Piccoli GB, Zakharova E, Attini R, Ibarra Hernandez M, Covella B, Alrukhaimi M, Liu Z-H, Ashuntantang G, Orozco Guillen A, Cabiddu G, Li PKT, Garcia-Garcia G, Levin A. Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases. Journal of Clinical Medicine. 2018; 7(10):318. https://doi.org/10.3390/jcm7100318

Chicago/Turabian Style

Piccoli, Giorgina B., Elena Zakharova, Rossella Attini, Margarita Ibarra Hernandez, Bianca Covella, Mona Alrukhaimi, Zhi-Hong Liu, Gloria Ashuntantang, Alejandra Orozco Guillen, Gianfranca Cabiddu, Philip K.T. Li, Gulliermo Garcia-Garcia, and Adeera Levin. 2018. "Acute Kidney Injury in Pregnancy: The Need for Higher Awareness. A Pragmatic Review Focused on What Could Be Improved in the Prevention and Care of Pregnancy-Related AKI, in the Year Dedicated to Women and Kidney Diseases" Journal of Clinical Medicine 7, no. 10: 318. https://doi.org/10.3390/jcm7100318

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