Acute renal injury

Acute kidney injury (AKI) is now a relatively uncommon complication of pregnancy. To understand AKI in pregnancy, it is necessary to be familiar with the physiological changes affecting the urinary system. Acute renal failure may result from a variety of intrinsic renal diseases similar to those in the non-pregnant patient. When renal ischemia is prolonged and persistent, acute tubular necrosis (ATN) develops. ATN has three phases: initiation, maintenance, and recovery, which depend on the severity of insult and proportion of unaffected residual nephrons. Acute glomerulonephritis (GN) may be responsible for AKI occurring during pregnancy. Inflammatory infiltration within the renal interstitial parenchyma and peritubular space defines acute interstitial nephritis (AIN). Treatment of AKI involves management of the underlying condition, containment of renal damage, and restoration of renal function. The prognosis for return of renal function depends on multiple variables, including baseline renal status and duration and etiology of AKI.