Acute Kidney Injury in Pregnancy: A Single-Center Study in Tunisia


Acute kidney injury is a rare but serious complication of pregnancy. It is still common in developing countries. The causes can be varied. It is imperative to distinguish these conditions to make appropriate therapeutic decisions which can be lifesaving for the mother and fetus. This study examined the incidence and etiology of acute kidney injury in pregnancy, the morbidity, fetomaternal mortality, and renal prognosis among pregnant patients developing acute kidney injury. This is a retrospective observational study involving cases of acute kidney injury during pregnancy and hospitalized in our department from 1995 to 2015. The study involved 10 patients. The average age of patients was 31.6 years. Personal history of preeclampsia was found in 2 patients. The average term of pregnancy in which appeared the acute kidney injury was 33 weeks. All patients had preeclampsia. Five of them had a retro-placental hematoma, 2 had eclampsia and another post-partum hemorrhage. Five patients underwent renal biopsy for a persistent acute kidney injury with an average delay of 26 days. The histological results were: partial cortical necrosis in one case, thrombotic microangiopathy in two cases, acute tubular necrosis in one case, and membranoproliferative glomerulonephritis in one case. Six of our patients had an antihypertensive treatment. Seven patients have required renal replacement therapy. The ultimate evolution was good in 9 patients with recovery of diuresis and total recovery of renal function. Only one patient had kept with advanced renal failure requiring hemodialysis. She has been transplanted after 2 years with normal graft function. The pregnancy care and quality of access to care remain fundamental to prevent complications of pregnancy, including acute kidney injury.

Share and Cite:

Gorsane, I. , Mahfoudhi, M. , El Euch, M. and Abdallah, T. (2015) Acute Kidney Injury in Pregnancy: A Single-Center Study in Tunisia. International Journal of Clinical Medicine, 6, 729-733. doi: 10.4236/ijcm.2015.610097.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Nwoko, R., Plecas, D. and Garovic, V.D. (2012) Acute Kidney Injury in the Pregnant Patient. Clinical Nephrology, 78, 478-486.
[2] Machado, S., Figueiredo, N., Borges, A., Pais, S.J.M., Freitas, L., Moura, P., et al. (2012) Acute Kidney Injury in Pregnancy: A Clinical Challenge. Journal of Nephrology, 25, 19-30.
[3] Goplani, K.R., Shah, P.R., Gera, D.N., Gumber, M., Dabhi, M., Feroz, A., et al. (2008) Pregnancy-Related Acute Renal failure: A Single-Center Experience. Indian Journal of Nephrology, 18, 17-21.
[4] Fakhouri, F., Vercel, C. and Frémeaux-Bacchi, V. (2012) Obstetric Nephrology: AKI and Thrombotic Microangiopathies in Pregnancy. Clinical Journal of the American Society of Nephrology, 7, 2100-2106.
[5] Krane, N.K. (1988) Acute Renal Failure in Pregnancy. Archives of Internal Medicine, 148, 2347-2357.
[6] Prakash, J., Niwas, S.S., Parekh, A., Pandey, L.K., Sharatchandra, L., Arora, P., et al. (2010) Acute Kidney Injury in Late Pregnancy in Developing Countries. Ren Fail, 32, 309-313.
[7] Ganesan, C. and Maynard, S.E. (2011) Acute Kidney Injury in Pregnancy: The Thrombotic Microangiopathies. Journal of Nephrology, 24, 554-563.
[8] Aggarwal, R.S., Mishra, V.V., Jasani, A.F. and Gumber, M. (2014) Acute Renal Failure in Pregnancy: Our Experience. Saudi Journal of Kidney Diseases and Transplantation, 25, 450-455.
[9] Gyamlani, G. and Geraci, S.A. (2013) Kidney Disease in Pregnancy: (Women’s Health Series). Southern Medical Journal, 106, 519-525.
[10] Grünfeld, J.P., Ganeval, D. and Bournérias, F. (1980) Acute Renal Failure in Pregnancy. Kidney International, 18, 179-191.
[11] Godara, S.M., Kute, V.B., Trivedi, H.L., Vanikar, A.V., Shah, P.R., Gumber, M.R., et al. (2014) Clinical Profile and Outcome of Acute Kidney Injury Related to Pregnancy in Developing Countries: A Single-Center Study from India. Saudi Journal of Kidney Diseases and Transplantation, 25, 906-911.
[12] Gul, A., Aslan, H., Cebeci, A., Polat, I., Ulusoy, S. and Ceylan, Y. (2004) Maternal and Fetal Outcomes in HELLP Syndrome Complicated with Acute Renal Failure. Ren Fail, 26, 557-562.
[13] Drakeley, A.J., Le Roux, P.A., Anthony, J. and Penny, J. (2002) Acute Renal Failure Complicating Severe Preeclampsia Requiring Admission to an Obstetric Intensive Care Unit. American Journal of Obstetrics & Gynecology, 186, 253-256.
[14] Selcuk, N.Y., Odabas, A.R., Cetinkaya, R., Tonbul, H.Z. and San, A. (2000) Outcome of Pregnancies with HELLP Syndrome Complicated by Acute Renal Failure (1989-1999). Ren Fail, 22, 319-327.
[15] Beaufils, M. (1998) Acute Renal Failure in a Special Setting. In: Stewart Cameron, J., Grunfeld, J.P., Kerr, D.N.S., Ritz, E. and Winearls, C.G., Eds., Oxford Textbook of Clinical Nephrology, Oxford University Press, Oxford, 1704-1713.
[16] Kuller, J.A., D’Andrea, N.M. and McMahon, M.J. (2001) Renal Biopsy and Pregnancy. American Journal of Obstetrics & Gynecology, 184, 1093-1096.
[17] Mattar, F. and Sibai, B.M. (2000) Eclampsia. VIII. Risk Factors for Maternal Morbidity. American Journal of Obstetrics & Gynecology, 182, 307-312.

Copyright © 2022 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.