title: Kidney injury during pregnancy: associated comorbid conditions and outcomes.
abstract: OBJECTIVE
  To investigate the characteristics of women who have kidney injury during pregnancy.
  
  
  METHODS
  Medical records of all women who gave birth at our institution between January 1, 2005, and December 31, 2010, were retrospectively reviewed electronically. We identified those who incurred a kidney injury [defined by modified Acute Kidney Injury Network (AKIN) criteria: serum creatinine (sCr) increase ≥0.3 mg/dL] during pregnancy or within 30 days postpartum. Identified case records were reviewed in detail.
  
  
  RESULTS
  During the study period, 54 women had a kidney injury (0.4 % estimated incidence) with a mean (SD) increase in sCr of 0.46 (0.29) mg/dL; most injuries were AKIN stage 1 with transient increases in sCr. Most of the women (n = 48, 87.3 %) had substantial preexisting or pregnancy-associated comorbid conditions (e.g., kidney disease, hypertension, diabetes), complications (e.g., preeclampsia, HELLP syndrome), or a complicated obstetric course (hemorrhage, infections) that could have contributed to the development of a kidney injury. Two patients had AKIN stage 3 injuries: a previously healthy patient who had a massive hemorrhage during cesarean delivery, and a patient with a renal transplant who had deterioration and eventual postpartum failure of her transplanted kidney.
  
  
  CONCLUSIONS
  The majority of pregnancy-associated kidney injuries were transient and occurred in women with substantial comorbid conditions or complicated pregnancies.
authors.affiliation: Department of Anesthesiology, Mayo Clinic, 200 First St SW, Rochester, MN 55905, USA.
authors.forename: Carmelina
authors.initials: C
authors.lastname: Gurrieri
authors.forename: Vesna D
authors.initials: VD
authors.lastname: Garovic
authors.forename: Antonino
authors.initials: A
authors.lastname: Gullo
authors.forename: Katarina
authors.initials: K
authors.lastname: Bojanić
authors.forename: Juraj
authors.initials: J
authors.lastname: Sprung
authors.forename: Bradly J
authors.initials: BJ
authors.lastname: Narr
authors.forename: Toby N
authors.initials: TN
authors.lastname: Weingarten
mesh_terms: D058186:Acute Kidney Injury / Q000453:epidemiology* / Q000209:etiology; D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D015897:Comorbidity; D017523:Croatia / Q000453:epidemiology; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000209:etiology; D012189:Retrospective Studies
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal