Division of Nephrology, Department of Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Division of Nephrology and Hypertension, Department of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA.
Clin Transplant. 2022 May;36(5):e14668. doi: 10.1111/ctr.14668. Epub 2022 Apr 17.
Pregnancy-related acute kidney injury (AKI) is a public health problem and remains an important cause of maternal and fetal morbidity and mortality. The incidence of pregnancy-related AKI has increased in developed countries due to increase in maternal age and higher detection rates. Pregnancy in women with kidney transplants is associated with higher adverse outcomes like preeclampsia, preterm births, and allograft dysfunction, but limited data exists on causes and outcomes of pregnancy-related AKI in the kidney transplant population. Diagnosis of AKI during pregnancy remains challenging in kidney transplant recipients due to lack of diagnostic criteria. Management of pregnancy-related AKI in the kidney transplant population requires a multidisciplinary team consisting of transplant nephrologists, high-risk obstetricians, and neonatologists. In this review, we discuss pregnancy-related AKI in women with kidney transplants, etiologies, pregnancy outcomes, and management strategies.
妊娠相关性急性肾损伤(AKI)是一个公共卫生问题,仍然是孕产妇和胎儿发病率和死亡率的重要原因。由于产妇年龄增加和更高的检测率,发达国家妊娠相关性 AKI 的发病率有所增加。肾移植女性的妊娠与子痫前期、早产和移植物功能障碍等不良结局相关,但关于肾移植人群中妊娠相关性 AKI 的病因和结局的数据有限。由于缺乏诊断标准,肾移植受者妊娠期间 AKI 的诊断仍然具有挑战性。肾移植人群妊娠相关性 AKI 的管理需要由移植肾脏病学家、高危产科医生和新生儿科医生组成的多学科团队。在这篇综述中,我们讨论了肾移植女性的妊娠相关性 AKI、病因、妊娠结局和管理策略。