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Diagnosis, diagnostic approach and challenges in pregnancy-associated AKI-the ADQI 32 consensus meeting

Nuttha Lumlertgul1,2, Rolando Claure-Del Granado3,4, Anjali Acharya5

  • 1Excellence Centre for Critical Care Nephrology, Division of Nephrology, Department of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Nephrology, Dialysis, Transplantation : Official Publication of the European Dialysis and Transplant Association - European Renal Association
|October 27, 2025
PubMed

Insights

Pregnancy-associated acute kidney injury (PrAKI) remains a serious concern, impacting maternal and fetal health. This review updates diagnostic tools and strategies for PrAKI, addressing challenges and offering recommendations.

Area of Science:

  • Nephrology
  • Obstetrics
  • Maternal Health

Background:

  • Pregnancy-associated acute kidney injury (PrAKI) poses significant risks to maternal and fetal well-being, despite obstetric care advancements.
  • Common causes include preeclampsia/eclampsia, hemorrhage, and infection, with diagnosis complicated by gestational stage and patient factors.

Purpose of the Study:

  • To provide an updated overview of diagnostic approaches and investigational tools for PrAKI.
  • To highlight current challenges in the diagnostic landscape of PrAKI.
  • To offer recommendations for clinical practice and future research directions in PrAKI diagnosis.

Main Methods:

  • Literature review of diagnostic modalities for PrAKI.
  • Analysis of traditional and novel diagnostic techniques.
  • Synthesis of current challenges and clinical recommendations.

Main Results:

  • Traditional methods like imaging and biopsy are complemented by emerging biomarkers for differential diagnosis.
  • Diagnostic accuracy is influenced by gestational age and individual risk profiles.
  • A comprehensive understanding of diagnostic tools is crucial for effective PrAKI management.

Conclusions:

  • Accurate and timely diagnosis of PrAKI is essential for improving maternal and fetal outcomes.
  • Integrating novel diagnostics with traditional methods can enhance differential diagnosis.
  • Further research and standardized clinical guidelines are needed to address PrAKI diagnostic challenges.

Keywords:
PrAKIacute kidney injurypregnancypregnancy-associated acute kidney injury

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