Pregnancy-related acute kidney injury requiring dialysis: experience from a tertiary hospital in Tanzania
Document Type
Artefact
Department
Internal Medicine (East Africa)
Abstract
Introduction
Women with pregnancy-related acute kidney injury (PRAKI) often present in a state of critical illness, commonly due to severe hypertensive disorders or other obstetric complications. Those requiring dialysis represent the most severe end of this spectrum, where outcomes are further worsened in low-resource settings by delayed diagnosis, limited access to timely nephrology care, and constrained critical care capacity. Despite this burden, data on pregnancy-related acute kidney injury requiring dialysis (PRAKI-D) in Tanzania are limited. This study describes the clinical characteristics and in-hospital outcomes of these patients at a tertiary hospital.
Methods
We conducted a retrospective cohort study at Muhimbili National Hospital, including all pregnant and post-partum women, defined as those who were pregnant, in labor, or within six weeks postpartum with PRAKI who received hemodialysis between January 2022 and December 2024. Data were extracted from medical records and included clinical characteristics, dialysis indications, and in-hospital outcomes. Descriptive statistics were used for analysis.
Results
We analyzed 112 patients with pregnancy-related acute kidney injury requiring dialysis, with a mean age of 31.3 (± 6.2) years. Most were referred from lower-level facilities (95.5%) and presented with acute kidney injury (AKI) stage three (51.8%) according to Kidney Disease: Improving Global Outcomes (KDIGO). Hypertensive disorders were the leading obstetric diagnosis (67%). At dialysis initiation, 68.8% were admitted to high-dependency or intensive care units, and 42.8% required ventilator support. In-hospital mortality was 17.9%. Among survivors, (67%) were lost to follow-up at three months.
Conclusion
Our findings highlight the high burden and adverse outcomes of pregnancy-related acute kidney injury requiring dialysis, emphasizing the need for earlier detection, improved referral systems, and integrated postpartum renal follow-up to reduce morbidity associated with acute kidney injury.
AKU Student
no
Publication (Name of Journal)
BMC Nephrology
DOI
https://doi.org/10.1186/s12882-025-04519-z
Recommended Citation
Ruggajo, P.,
Msilanga, D.,
Mngumi, J.,
Msangi, E.,
Valentine, G.,
Nkwera, U.,
Shoo, J.,
Batanyita, J.,
Riziki, H.,
Didi, J.
(2025). Pregnancy-related acute kidney injury requiring dialysis: experience from a tertiary hospital in Tanzania. BMC Nephrology, 26(592).
Available at:
https://ecommons.aku.edu/eastafrica_fhs_mc_intern_med/506