Szczepanski Jamie, Griffin Ashley, Novotny Sarah, Wallace Kedra
Department of Obstetrics and Gynecology, University of Mississippi Medical Center, Jackson, MS, United States.
Program in Neuroscience, University of Mississippi Medical Center, Jackson, MS, United States.
Front Med (Lausanne). 2020 Feb 7;7:22. doi: 10.3389/fmed.2020.00022. eCollection 2020.
Acute kidney injury that occurs during pregnancy or in the post-partum period (PR-AKI) is a serious obstetric complication with risk of significant associated maternal and fetal morbidity and mortality. Recent data indicates that the incidence of PR-AKI is increasing, although accurate calculation is limited by the lack of a uniform diagnostic criteria that is validated in pregnancy. Hypertensive and thrombotic microangiopathic disorders of pregnancy have been identified as major contributors to the burden of PR-AKI. As is now accepted regarding preeclampsia, HELLP syndrome and atypical hemolytic uremic syndrome, it is believed that PR-AKI may have long-term renal, cardiovascular and neurocognitive consequences that persist beyond the post-partum period. Further research regarding PR-AKI could be advanced by the development of a pregnancy-specific validated definition and classification system; and the establishment of refined animal models that would allow researchers to further elucidate the mechanisms and sequelae of the disorder.
妊娠期间或产后发生的急性肾损伤（PR-AKI）是一种严重的产科并发症，有显著的孕产妇和胎儿发病及死亡风险。近期数据表明，PR-AKI的发病率正在上升，不过由于缺乏在妊娠中得到验证的统一诊断标准，准确计算受到限制。妊娠高血压和血栓性微血管病已被确定为PR-AKI负担的主要促成因素。正如现在关于子痫前期、HELLP综合征和非典型溶血性尿毒症综合征所公认的那样，人们认为PR-AKI可能会产生长期的肾脏、心血管和神经认知后果，这些后果在产后仍会持续。关于PR-AKI的进一步研究可以通过制定经过验证的妊娠特异性定义和分类系统以及建立完善的动物模型来推进，这将使研究人员能够进一步阐明该疾病的机制和后遗症。
