Kontomanolis Emmanuel N, Prokopakis Ioannis, Koutras Antonios, Andreou Emmanouil, Metaxas Dionysios, Boulieris Gerasimos, Zachariou Eleftherios, Sapantzoglou Ioakeim, Papageorgiou Dimitrios, Palios Vasileios-Chrysovalantis, Karachalios Charalampos, Papadimitriou Angeliki, Daglas Konstantinos, Chionis Athanasios, Lagadas Antonios, Perros Paraskevas
Department of Obstetrics and Gynecology, Democritus University of Thrace, 68100 Alexandroupolis, Greece.
1st Department of Obstetrics and Gynecology, National and Kapodistrian University of Athens, General Hospital of Athens 'ALEXANDRA', 11528 Athens, Greece.
J Clin Med. 2025 Aug 26;14(17):6031. doi: 10.3390/jcm14176031.
Pregnancy-Related Acute kidney injury (PRAKI) is a critical complication of pregnancy, defined by the sudden deterioration in renal function during gestation or within the initial six weeks postpartum. Pregnancy is thought to increase the risk of acute kidney injury (AKI) by 51%. This is linked to the anatomical alterations that occur during pregnancy and special conditions, such as preeclampsia/eclampsia. PRAKI's epidemiology and outcome vary between developed and developing nations. PRAKI is an uncommon entity in high-income countries; however, its incidence has recently increased. The aim of this systematic review is to evaluate the maternal and perinatal outcomes and risk factors affecting pregnancies affected by AKI. Comprehensive research was performed in PubMed/Medline, Scopus, and Google Scholar electronic databases from 2015 up to January 2025, using the terms AKI, PRAKI, sepsis, preeclampsia/eclampsia, liver enzymes, low platelet count (HELLP) syndrome, and pregnancy. After a thorough assessment, 25 full-text articles were obtained. Our results revealed that preeclampsia, eclampsia, HELLP syndrome, and antepartum and postpartum hemorrhage predispose women to PRAKI. Other unusual factors, like disseminated intravascular coagulation (DIC) or hemolytic uremic syndrome (HUS), should not be underestimated. Furthermore, the latest published data showed unfavorable maternal and fetal outcomes in pregnancies affected by AKI compared to the general population. PRAKI constitutes a serious pregnancy complication that requires immediate treatment. The higher prevalence of PRAKI in developing countries (4-26%) versus wealthy nations (1.0-2.8%) has considerably indicated the impact of socioeconomic status and the accessibility of health services.
妊娠相关急性肾损伤（PRAKI）是妊娠的一种严重并发症，定义为妊娠期或产后最初六周内肾功能突然恶化。妊娠被认为会使急性肾损伤（AKI）的风险增加51%。这与妊娠期间发生的解剖学改变以及子痫前期/子痫等特殊情况有关。PRAKI的流行病学和结局在发达国家和发展中国家有所不同。在高收入国家，PRAKI是一种不常见的疾病；然而，其发病率最近有所上升。本系统评价的目的是评估受AKI影响的妊娠的孕产妇和围产期结局以及危险因素。使用AKI、PRAKI、败血症、子痫前期/子痫、肝酶、低血小板计数（HELLP）综合征和妊娠等术语，于2015年至2025年1月在PubMed/Medline、Scopus和谷歌学术电子数据库中进行了全面检索。经过全面评估，获得了25篇全文文章。我们的结果显示，子痫前期、子痫、HELLP综合征以及产前和产后出血使女性易患PRAKI。其他不常见的因素，如弥散性血管内凝血（DIC）或溶血尿毒综合征（HUS），也不应被低估。此外，最新发表的数据显示，与一般人群相比，受AKI影响的妊娠的孕产妇和胎儿结局不佳。PRAKI是一种严重的妊娠并发症，需要立即治疗。发展中国家PRAKI的患病率较高（4-26%），而富裕国家为（1.0-2.8%），这充分表明了社会经济地位和卫生服务可及性的影响。
