Pregnancy-associated acute kidney injury as an important driver of chronic kidney disease in females in developing countries: A systematic review

Up to one-third of PR-AKI patients may develop CKD and remain dialysis-dependent during follow-up. PR-AKI significantly impacts both maternal and fetal morbidity and mortality. Early prevention and prompt management by healthcare professionals are critical to improving outcomes in PR-AKI. Pregnancy-related acute kidney injury (PR-AKI) significantly affects maternal and fetal health, leading to high mortality and long-term complications such as chronic kidney disease (CKD). This systematic review, focusing on developing countries like India, evaluated the burden of CKD due to PR-AKI patients. The review analyzed Indian studies published between 2000 and June 2024, including 25 studies with 2,306 participants. PR-AKI incidence ranged from 1 to 12%, with sepsis being the leading cause in up to 78% of cases, followed by hypertensive disorders, obstetric hemorrhage, and tropical fevers. RRT was needed in 20-85% of patients, and 12.8-35% developed CKD during follow-up, with up to 30% remaining dialysis-dependent. Maternal mortality varied from 2.5 to 34%, while perinatal mortality reached 67.3%. The study emphasizes the critical need for early prevention timely intervention and need for long-term follow-up to reduce the high morbidity and mortality rates associated with PR-AKI.