{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T19:13:25Z","timestamp":1792178005685,"version":"4.4.0"},"reference-count":0,"publisher":"Jaypee Brothers Medical Publishing","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAPI"],"published-print":{"date-parts":[[2022,8,7]]},"abstract":"<jats:p>Background: Pregnancy-related acute kidney injury (PRAKI) is a common problem in the developing world.  Materials and methods: In this retrospective observational study at a tertiary care hospital in South India we evaluated records for the maternal, fetal, and renal outcomes in women with PRAKI.  Results: Over a 10-year period, 395 patients of PRAKI were seen constituting 8.1% of all acute kidney injury (AKI). The mean age of patients was 27 \u00b1 3 years. A total of 176 (44.5%) had pre-eclampsia, 132 (33.4%) had puerperal sepsis, 76 (19.2%) had antepartum hemorrhage or postpartum hemorrhage (APH 30\/PPH 46), nine (2.2%) had hemolytic uremic syndrome (HUS). Obstruction was seen in two patients. Eleven had underlying glomerulonephritis out of three had lupus nephritis. Forty-five of 395 (11.39%) had hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome, that is, 25.5% of those with pre-eclampsia. Sixteen (4.0%) had placental abruption. A total of 288 (72.9%) presented postpartum. Renal biopsy done in 103 (26%) showed patchy cortical necrosis (PCN) in 25 (22.3%), diffuse cortical necrosis (DCN) in 23 (20.3%), acute tubular necrosis (ATN) in 20 (19.4%), acute interstitial nephritis (AIN) in 10 (9.7%), while nine (8.7%) had thrombotic microangiopathy (TMA). Glomerular disease was seen in 11. Cortical necrosis (CN) was seen in 48 patients of which 10 (20.83%) had abruption placenta, 25 (52%) had puerperal sepsis, 11 (22.9%) had postpartum hemorrhage (PPH), and two (4.1%) had TMA. A total of 290 (73.4%) required dialysis. About 76% improved while 8.3% progressed to end-stage renal disease (ESRD).  Maternal mortality (MM) was 5%. There were 42 intrauterine deaths and 30 deaths in the neonatal period.  Discussion: Pregnancy-related acute kidney injury in developing countries is more common as compared to the West. Only 49% patients had booked pregnancy, that is, received regular antenatal care. Apart from pre-eclampsia which is also the major cause in the West and was the etiology in 44% of patients with PRAKI in our study, sepsis (33%) and maternal hemorrhage (19%) were also significant. Immediate recovery from PRAKI was 75% however about 8% develop end-stage kidney disease (ESKD) while in the west ESKD occurred in only about 2%.  Conclusion: Pregnancy-related acute kidney injury is an important cause of maternal and fetal morbidity and mortality. Pre-eclampsia emerged as the most common cause of PRAKI and CN was the most common histological lesion. Proper antenatal care and management may improve pregnancy outcomes.<\/jats:p>","DOI":"10.5005\/japi-11001-0064","type":"journal-article","created":{"date-parts":[[2023,4,11]],"date-time":"2023-04-11T05:05:03Z","timestamp":1681189503000},"page":"63-68","source":"Crossref","is-referenced-by-count":9,"title":["Pregnancy-related Acute Kidney Injury in Public Hospital in South India: Changing Trends"],"prefix":"10.59556","volume":"70","author":[{"given":"Manisha","family":"Sahay","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priya","family":"shree","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luvdeep","family":"Dogra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kiranmai","family":"Ismal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sharmas","family":"Vali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2914","published-online":{"date-parts":[[2022,8,1]]},"container-title":["Journal of the Association of Physicians of India"],"original-title":[],"deposited":{"date-parts":[[2025,4,25]],"date-time":"2025-04-25T10:57:25Z","timestamp":1745578645000},"score":1,"resource":{"primary":{"URL":"https:\/\/japi.org\/article\/files\/JAPI0064_p63-68.pdf"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,1]]},"references-count":0,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,8,1]]},"published-print":{"date-parts":[[2022,8,7]]}},"URL":"https:\/\/doi.org\/10.5005\/japi-11001-0064","relation":{},"ISSN":["0004-5772"],"issn-type":[{"value":"0004-5772","type":"print"}],"subject":[],"published":{"date-parts":[[2022,8,1]]}}}