Clinical Profile and Outcomes of Women with Postpartum Acute Kidney Injury at a Tertiary Level Hospital in Chattogram, Bangladesh

Background: Postpartum acute kidney injury (PPAKI) remains a significant cause of maternal morbidity and mortality, particularly in low- and middle-income countries where delays in diagnosis and referral are common. Objective: The present study was conducted to evaluate the clinical spectrum, management, and outcomes of postpartum AKI, with emphasis on associated risk factors and KDIGO staging. Materials and methods: This prospective observational study was conducted in the Department of Obe’s and Gynae and the Department of Nephrology in a tertiary hospital in Bangladesh including among 83 postpartum patients diagnosed with AKI according to KDIGO criteria. Recruited patients were monitored during their hospital stay and after three months to exclude chronic kidney disease and to determine the prognosis. Results: The mean age of the patients was 25.7 ± 6.1 years, and most (88%) resided in rural areas. The majority were multiparous (68.7%) of low-income background (63.9%) and had received some antenatal care (78.3%). Cesarean section was the most common mode of delivery (56.6%) and institutional delivery occurred in 88% of cases. Among risk factors, preeclampsia (41%) and postpartum hemorrhage (34.9%) were frequent. Most patients (75.9%) presented with KDIGO stage 3 AKI and 75.9% required hemodialysis. Complete renal recovery occurred in 41%, while 43.4% of patients died. Lack of antenatal care was significantly associated with poor outcomes (p = 0.044). Although outcome worsened with higher KDIGO stage, the difference was not statistically significant (p = 0.225). Conclusion: In this setting, most of the women with PPAKI presented with severe (Stage 3) disease. Mortality and incomplete recovery were frequent, particularly among those without antenatal care and those requiring dialysis. Chatt Maa Shi Hosp Med Coll J; Vol.25 (2); July 2026; Page 25-32