Rising rates of kidney injury in women who are hospitalized during pregnancy

A recent analysis reveals increasing rates of acute kidney injury in women who are hospitalized during pregnancy, especially among those with diabetes. Also, women with pregnancy-related acute kidney injury were much more likely to die while in the hospital than those without kidney injury. The findings will be presented at ASN Kidney Week 2019 November 5-November 10 at the Walter E. Washington Convention Center in Washington, DC.

Kidney injury during pregnancy is associated with significant maternal and fetal morbidity and mortality. To study the issue, Silvi Shah, MD (University of Cincinnati) and her colleagues analyzed records from the 2006-2015 Nationwide Inpatient Sample, a US database containing information on more than 7 million hospital stays each year.

The researchers identified 42,190,790 hospitalizations during pregnancy, and the overall rate of hospitalizations involving acute kidney injury was 0.08%. The rate increased from 0.04% in 2006 to 0.12% in 2015. Women with pregnancy-related acute kidney injury were older than those who did not develop acute kidney injury. Pregnancy-related acute kidney injury occurred at a higher rate in black women than white women, and in women with diabetes than in those without diabetes. The rate of pregnancy-related hospitalization involving acute kidney injury in diabetic women increased from 0.36% in 2006 to 1.10% in 2015.

Higher rates were observed in southern and midwest geographical regions than in the northeast region, and in urban teaching hospitals than in urban non-teaching hospitals and rural hospitals.

Women with pregnancy-related acute kidney injury were much more likely to die while in the hospital than those without kidney injury (3.98% vs. 0.01%).

"The findings of our study may necessitate change in nationwide policies regarding obstetric care of women and emphasize the need for kidney health monitoring for women hospitalized during pregnancy and during their outpatient prenatal visits," said Dr. Shah.