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Dr Rushi Deshpande, Mumbai 02 December 2019

Acute kidney injury (AKI) in pregnancy is associated with both increased maternal and fetal mortality.
Although the overall incidence of AKI in pregnancy in most of the world is declining, the absolute numbers of deaths from AKI remain unacceptably high.
Initiative to improve maternal and fetal outcomes are needed both in the developing and developed world.
Diagnosis of pregnancy-related AKI is not always straightforward and can be quite challenging in those with overlapping features such as pre-eclampsia/HELLP, AFLP, hemolytic uremic syndrome/thrombotic thrombocytopenic purpura (HUS/TTP), atypical HUS and lupus nephritis.
Measuring angiogenic factors may prove to be helpful in making the diagnosis of pre-eclampsia.
Excluding the use of eculizumab for a HUS and plasma exchange for TTP, treatment of AKI in pregnancy is generally supportive, often coupled with expedient delivery.
AKI-even resolved is a risk factor for future adverse pregnancy outcomes.
Research should focus on disease-specific diagnostic markers, with awareness that prompt availability of results is necessary to affect management decisions and impact outcomes.

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