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Kidney Injury May Cause Pregnancy Complications

RMKidney

Pregnancy is one of the most joyous and miraculous experiences that any women and family, on the whole, can experience. However, a new study has found that women who have experienced or have a history of acute kidney injury may be at a greater risk of preeclampsia and other pregnancy complications. Here’s the kicker – the results are the same even when kidney function is normal prior to the pregnancy.

Dr. Jessica Sheehan Tangren, of the Division of Nephrology at Massachusetts General Hospital in Boston, was the leader of the study and believes that the results indicate a growing importance for obstetricians to do a little digging in order to get a clear picture of the past kidney health for pregnant women.

So what is acute kidney disease? Also known as AKI, it is the sudden onset of kidney damage or failure, which is a condition that can lead to an accumulation of waste products in the blood, an imbalanced amount of bodily fluids, as well as the potential to impact the function of other organs including the brain, heart, and lungs.

While acute kidney injury is most common in older adults, it isn’t unheard of for it to occur in children and young adults, which, as this study shows, can lead to future complications.

While most people don’t often think of an acute kidney injury as the type of ailment that is likely to affect them, the fact remains that the causes behind an AKI are numerous. From severe infections to allergic reactions, and from low blood pressure to surgery, the kidney is often an organ where seemingly unrelated catalysts can cause problems.

But how does it relate to pregnancy?

Dr. Tangren and her colleagues make note that existing kidney disease is known to increase the likelihood of pregnancy complications for expectant mothers; however, the goal of the study was to investigate how a history of AKI might impact the pregnancy.

In order to do that, the team analyzed the medical records of 24,745 women who gave birth at Massachusetts General Hospital between 1998-2007. Of these women, 24,640 had no history of kidney disease (the controls), while 105 had a history of AKI, from which they had fully recovered prior to pregnancy.

The results – compared with women who had no history of kidney disease, those with a history of recovered AKI were found to be at much greater risk of pregnancy complications. That translates to a risk of preeclampsia that is 5.9 times greater with a history of AKI than without.

“We know that kidneys undergo major changes during pregnancy, and that sort of ‘renal stress test’ may reveal previously undetected kidney disease in women with a history of acute kidney injury,” notes Dr. Tangren.

“Information like this helps obstetric providers know what to be vigilant for in pregnant women with a history of acute kidney injury and indicates that asking about such history is important,” notes study co-author Dr. Jeffrey Ecker, chief of obstetrics and gynecology at MGH.
“Being especially watchful for signs and symptoms of preeclampsia in such patients is one immediate application of this work,” he adds.

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