Pregnancy-related AKI rates rising, especially for women with diabetes
WASHINGTON — The rate of women hospitalized for acute kidney injury during pregnancy has increased in recent years and is associated with high rates of in-patient mortality, according to research presented at ASN Kidney Week. The risk for pregnancy-related AKI is greatest for women with diabetes, according to the study.
“We were interested to know the trends in AKI among pregnancy-related hospitalizations and factors associated with it, including race/ethnicity and diabetes,” Silvi Shah, MD, MS, FACP, FASN, assistant professor in the division of nephrology at the University of Cincinnati, told Healio Nephrology. “Although the incidence of AKI during pregnancy-related hospitalizations was low, the rates increased almost three-fold between 2006 and 2015.”
After identifying 15,550,459 hospitalizations, researchers found the rate of pregnancy-related hospitalization involving AKI was 0.1%, subsequently increasing from 0.09% in 2012 to 0.12% in 2015. Women who developed pregnancy-related AKI were more likely to be older (mean age, 40 vs. 30 years) and black (0.25% vs. 0.07% for white women).
For women with diabetes, researchers observed a higher likelihood of pregnancy-related AKI than those without (1.1% vs. 0.1%), with the rate increasing from 0.9% in 2012 to 1.2% in 2015. While all women with pregnancy-related AKI had higher in-hospital mortality than those without AKI (2.6% vs. 0.01%), the presence of diabetes did not appear to increase mortality risk.
Shah told Healio Nephrology that she speculates the finding of increasing rates of AKI during pregnancy-related hospitalizations is likely due to greater awareness and detection of AKI during pregnancy, although she said further research is needed to confirm this. In addition, the reasons for racial and ethnic differences in AKI rates remain unclear.
She encourages clinicians to routinely check renal panels during in-patient hospitalizations. Further, she said, “the present study suggests that implementation of specific interventions for the prevention, diagnosis and management of AKI in pregnant women may reduce the burden of AKI during hospitalizations in the United States.” – by Melissa J. Webb
Shah S, et al. Abstract SA-OR011. Presented at: ASN Kidney Week; Nov. 7-10, 2019; Washington, D.C.
Disclosure: Shah reports she has no relevant financial disclosures.