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Abstract: FR-PO080

AKI During Pregnancy: Baseline Characteristics and Long-Term Outcomes

Session Information

Category: Acute Kidney Injury

  • 101 AKI: Epidemiology‚ Risk Factors‚ and Prevention

Authors

  • Hafid, Mistafa, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Akkari, Abdel-Rauof M., Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Salameh, Omar Khaleel Mohammad, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Abdulbasit, Muhammad, Penn State College of Medicine, Hershey, Pennsylvania, United States
  • Ghahramani, Nasrollah, Penn State College of Medicine, Hershey, Pennsylvania, United States
Background

Pregnancy-related acute kidney injury (AKI) is a serious public health problem and is an important cause of maternal and fetal morbidity and mortality. The incidence of pregnancy-related AKI has increased due to increase in maternal age and higher detection rates. Using a large multicenter cohort, we analyzed the differences in demographic characteristics in pregnant women who developed AKI during pregnancy with those who did not develop AKI.

Methods

We performed a retrospective multi-center cohort study using TriNetX Research Network database, a federated medical records network, to identify 1,537,027 pregnant women from 46 healthcare organizations (HCOs) in the United States. From this group, we then identified women who has a confirmed diagnosis of AKI during their pregnancy. We calculated the odds ratio (OR) and 95% confidence interval (CI) of diagnosis offend Stage Renal Disease (ESRD) and death in the first five years after pregnancy.

Results

4,867 pregnant women (from 40 HCOs) had a confirmed diagnosis of AKI during pregnancy. Compared with the non-AKI group, women in the AKI group were older (37.9 ± 17.5 vs. 31.4 ± 8.9; p <0.0001) and more likely to:
● be African American (p<0.001)
● have a Body Mass Index (BMI) > 30 kg/m2 (p<0.001)
● have a BMI < 20 kg/m2 (p<0.001)
● be nicotine dependent during pregnancy (p<0.001)

Within the first five years after pregnancy, a total of 4798 women (434 with AKI) were diagnosed with ESRD and 5136 women (550 with AKI) died. After propensity matching, AKI was associated with higher odds of ESRD (OR: 33.6; CI:30.4 to 37.3), and mortality (OR: 41.7; CI: 38.0 to 45.8).

Conclusion

Among pregnant women, those who developed AKI during pregnancy were more likely to be older at time of pregnancy, African American, have a BMI above 30 kg/m2 or below 20 kg/m2 , and to be nicotine dependent during pregnancy. AKI during pregnancy was associated with higher likelihood of ESRD and death within five years after pregnancy.