Introduction:
Pregnancy-related acute kidney injury (AKI) is one of the most common causes of renal cortical necrosis (RCN). Although this complication has virtually disappeared in high-income countries, RCN remains a significant concern in the developing world, particularly as a complication of pregnancy. The exact pathogenesis of RCN in this obstetric setting remains unresolved. In this case series we describe cases of pregnancy-related renal cortical necrosis.
Methods:
Study Design: This study is a retrospective case series.
Setting and Participants: We retrospectively identified 16 patients from our nephrology department who developed renal cortical necrosis (RCN) following the postpartum state. The study period spanned from January 2023 to August 2024.
Methods: All cases of acute cortical necrosis in the postpartum setting were included. The diagnosis of renal cortical necrosis was confirmed either by contrast-enhanced computerized tomography (CT), which revealed a non-enhancing renal cortex with an enhancing medulla and no excretion of contrast media, or through renal biopsy.
Results:
We studied the obstetrical and renal features, therapeutic measures, and kidney disease outcomes.
A total of 16 patients presented with RCN during the postpartum period. Among them, 02 patients(12%) recovered completely within 6 months of the onset of AKI with normal renal function. 06 patients(37.5%) recovered partially, resulting in non-dialysis-dependent chronic kidney disease (CKD), while 08 patients(50%)remained on maintenance hemodialysis. None of the patients died due to RCN or obstetrical complications. The Etiology of Acute cortical necrosis in the postpartum period was sepsis and postpartum haemorrhage in all cases.
Conclusions:
Acute kidney injury due to renal cortical necrosis is common in the postpartum period. This condition requires timely management, and more investigations are necessary to understand its pathogenesis further and optimize treatment strategies.The primary limitation of this study is its retrospective design and small sample size.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.