Kidney Week

Abstract: FR-PO0969

Pregnancy-Associated AKI and Preterm Birth: Experience from an Obstetric Reference Center in Mexico

Session Information

• Women's Health and Kidney Diseases
  October 23, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Women's Health and Kidney Diseases

• 2100 Women's Health and Kidney Diseases

Authors

• Lopez, Diana Laura, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Diana Laura Lopez, MD

• Lopez Gonzalez, Ixchel Donaji, Instituto Nacional de Perinatologia, Mexico City, Mexico

Ixchel Donaji Lopez Gonzalez, MD

• Nares-Torices, Miguel Angel, Instituto Nacional de Perinatologia, Mexico City, Mexico

Miguel Angel Nares-Torices, DrMed

• Rosales, Luis Alejandro, Instituto Nacional de Cancerologia, Mexico City, Mexico

Luis Alejandro Rosales

• Lopez-Gil, Salvador, Instituto Nacional de Cardiologia Ignacio Chavez, Mexico City, Mexico

Salvador Lopez-Gil, MD

• Ramos De Jesus, Guadalupe, Instituto Nacional de Perinatologia, Mexico City, Mexico

Guadalupe Ramos De Jesus, MD

• Orozco-Guillen, Alejandra, Instituto Nacional de Perinatologia, Mexico City, Mexico

Alejandra Orozco-Guillen, DrMed, MSc

Background

Pregnancy-related acute kidney injury (P-AKI) is a frequently overlooked complication. It can have catastrophic consequences, particularly in countries with limited resources by contributing to preterm birth (PB) and neonatal mortality. This study aimed to evaluate the incidence of P-AKI and its associated maternal and fetal outcomes among women at a main tertiary care center in Mexico City.

Methods

Retrospective study of women in obstetric intensive care from January 2024 -April 2026. We classified AKI with KDIGO stages 1–3. Primary outcome was PB, secondary outcomes were admission to NICU, correlation between AKI severity and gestational age at birth, length of mother's ICU stay and recovery from AKI. Associations were summarized using event rates by KDIGO stage, odds ratios (ORs) with 95% confidence intervals (CIs), and Fisher's exact test.

Results

Total 68 patients, median age 32 (26–36.2) 82.8% were admitted to the ICU due to a hypertensive disorder. 81.4% experienced HELLP syndrome, 20.3% had pre-existing chronic hypertension and 12.5% pre-existing nephropathy. PB rates increased with increasing AKI severity: 27/38 (71.1%) G1, 11/14 (78.6%) G2 and 8/8 (100%) G3. Compared with stage 1, stages 2–3 showed higher odds of PB (OR 2.58; 95% CI 1.63–4.52; p = 0.019); this trend was statistically significant (p = 0.042). Admission to the NICU occurred in 40.2% of cases and was more frequent in stages G2–G3 than in stage G1 (56.3% vs. 25.8%; OR 3.70; 95% CI 1.03–4.73; p = 0.039). G2-3 was associated with higher odds of any PB (OR 3.93, 95% CI 1.76-5.37; p=0.025) and of severe PB (before 32 weeks) (OR 2.92, 95% CI 1.66-4.79; p=0.044). There was a positive correlation between KDIGO stage and PB severity.

Conclusion

Pregnancies complicated by AKI were associated with a high incidence of PB and admission to neonatal intensive care, suggesting that AKI during pregnancy contributes to prematurity and neonatal morbidity. The incidence of AKI during pregnancy was high, the leading cause was hypertensive disorders of pregnancy.