Acute Kidney Injury and Renal Replacement Therapy

While acute kidney injury (AKI) rarely affects pregnancy, it may be associated with significant morbidity and mortality. Women are conceiving at older ages, have higher body mass indices, and are more likely to have baseline comorbidities including hypertension, diabetes, and chronic kidney disease, predisposing them to renal injury. Pregnancies affected by renal failure are more likely to result in fetal/neonatal complications such as low birth weight, fetal growth restriction, and premature delivery. AKI includes a wide range of abrupt changes to kidney function ranging from mild elevations in serum Cr to acute need of renal replacement therapy (RRT). Treatment of AKI involves management of the underlying condition, containment of renal damage, and restoration of renal function. Close monitoring for signs and symptoms of electrolyte abnormalities is essential in AKI management. The two most used RRT modalities are continuous renal replacement therapy and intermittent hemodialysis.