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The Changing Landscape of Acute Kidney Injury in Pregnancy from an Obstetrics Perspective

1
Department of Obstetrics & Gynaecology, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, UK
2
Department of Obstetrics & Gynaecology, St. George’s University Hospital NHS Foundation Trust, London SW17 0QT, UK
3
Department of Nephrology and Transplantation, St. George’s University Hospital NHS Foundation Trust, London SW17 0QT, UK
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(9), 1396; https://doi.org/10.3390/jcm8091396
Received: 7 July 2019 / Revised: 26 August 2019 / Accepted: 30 August 2019 / Published: 6 September 2019
Pregnancy-related acute kidney injury (PR-AKI) is a heterogeneous disorder with multiple aetiologies that can occur at any time throughout pregnancy and the post-partum period. PR-AKI is an important obstetric complication that is associated with significant maternal and foetal morbidity and mortality. Although there has been an overall decline in the incidence of PR-AKI worldwide, a recent shift in the occurrence of this disease has been reported. Following improvements in obstetric care, PR-AKI incidence has been reduced in developing countries, whereas an increase in PR-AKI incidence has been reported in developed countries. Awareness of the physiological adaptations of the renal system is essential for the diagnosis and management of kidney impairment in pregnancy. In this review we scrutinize the factors that have contributed to the changing epidemiology of PR-AKI and discuss challenges in the diagnosis and management of acute kidney injury (AKI) in pregnancy from an obstetrics perspective. Thereafter we provide brief discussions on the diagnostic approach of certain PR-AKI aetiologies and summarize key therapeutic measures. View Full-Text
Keywords: pregnancy; kidney; physiology of pregnancy; acute kidney injury; pregnancy-related acute kidney injury pregnancy; kidney; physiology of pregnancy; acute kidney injury; pregnancy-related acute kidney injury
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Vinturache, A.; Popoola, J.; Watt-Coote, I. The Changing Landscape of Acute Kidney Injury in Pregnancy from an Obstetrics Perspective. J. Clin. Med. 2019, 8, 1396.

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