Acute kidney injury during pregnancy with favorable obstetric and nephrological outcome

The development of acute kidney injury (AKI) in pregnant women is a serious problem in both obstetrics and nephrology, as it is associated with a high risk of maternal and perinatal death. Pregnancy itself refers to risk factors for the development of AKI, and in case of pregnancy, the risk factors for the development of AKI are age, preeclampsia (PE) in the anamnesis, concomitant diseases such as diabetes mellitus, kidney and liver diseases. In late pregnancy, the causes of AKI may be PE, placental abruption, acute fatty liver dystrophy of pregnant women, thrombotic thrombocytopenic purpura, hemolytic-uremic syndrome, etc. Difficulties may arise at all stages of pregnancy management: when identifying the causes of AKI, at the treatment stage, when deciding on the possibility of prolongation of pregnancy. The article describes the clinical observation of stage III AKI of infectious genesis at 18—19 weeks of gestation, which required hemodialysis treatment (a total of 13 sessions), with subsequent complete restoration of kidney function and a favorable obstetric outcome. At 38 weeks of pregnancy, spontaneous labor occurred, a healthy girl weighing 3640 g and 50 cm tall was born, with 8/9 Apgar score. Therapy of pregnant women with AKI should be carried out by a multidisciplinary team consisting of an obstetrician-gynecologist, nephrologist, intensive care specialist, urologist, neonatologist.