Clinical profile, etiology and outcome of patients with pregnancy related acute kidney injury attending a tertiary care hospital in  Goa, India

Mudasir Habib; Jai Prakash Tiwari; Hasil Mohammed Ali Edakkunnummel; Sumit Tyagi; Tejaswini Bhatlawande; Bipasa Kar

doi:10.18203/2320-6012.ijrms20263098

Authors

Mudasir Habib Department of Nephrology, Goa Medical College, Goa, India
Jai Prakash Tiwari Department of Nephrology, Goa Medical College, Goa, India
Hasil Mohammed Ali Edakkunnummel Department of Nephrology, Goa Medical College, Goa, India
Sumit Tyagi Department of Nephrology, Goa Medical College, Goa, India
Tejaswini Bhatlawande Department of Nephrology, Goa Medical College, Goa, India
Bipasa Kar Department of Nephrology, Goa Medical College, Goa, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20263098

Keywords:

Pregnancy-related acute kidney injury, Sepsis, Preeclampsia, Chronic kidney disease

Abstract

Background: Pregnancy-related acute kidney injury (PRAKI) remains a significant contributor to maternal morbidity and mortality in developing countries, despite a global decline in incidence. Data from Indian tertiary care centers continue to demonstrate a predominance of preventable obstetric and infectious causes.

Methods: This combined prospective and retrospective observational study included pregnant women aged 18-42 years diagnosed with PRAKI at Goa Medical College. Patients with pre- existing kidney disease were excluded. Demographic variables, obstetric profile, etiologies, severity of AKI (KDIGO criteria), need for renal replacement therapy, and renal outcomes were analyzed.

Results: Seventy-two women were included, with a mean age of 30.6±5.5 years. Most patients presented in the third trimester (88.9%). Sepsis was the most common etiology (41.6%), followed by preeclampsia (22.2%) and postpartum hemorrhage (12.5%). Severe AKI predominated with 59.7% classified as KDIGO stage 3. Complete renal recovery occurred in 55.6% of patients, partial recovery in 26.4%, while 8.3% became dialysis-dependent. Overall mortality was 9.7%. Progression to chronic kidney disease (CKD) was observed in 35% of patients during follow-up.

Conclusions: PRAKI continues to cause substantial renal morbidity and mortality. Sepsis and hypertensive disorders of pregnancy remain the leading etiologies. Early diagnosis, timely intervention, and long-term renal follow-up are crucial to improving outcomes.

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