Silvi Shah, MD, MS, FACP, FNKF, FASN Assistant Professor Division of Nephrology, University of Cincinnati Cincinnati, OH-45267

Pregnancy: Age, Diabetes and Ethnicity Linked to Increased Risk of Kidney Injury Interview with:

Silvi Shah, MD, MS, FACP, FNKF, FASN Assistant Professor Division of Nephrology, University of Cincinnati Cincinnati, OH-45267

Dr. Shah

Silvi Shah, MD, MS, FACP, FNKF, FASN
Assistant Professor Division of Nephrology
University of Cincinnati
Cincinnati, OH-45267 What is the background for this study?

Response: The study identified 42,190,790 pregnancy related hospitalizations between Jan. 1, 2006 and Dec. 31, 2015, using data from the from the Nationwide Inpatient Sample. What are the main findings?

Response: The rate of AKI during pregnancy related hospitalization was 0.08% and the rate increased from 0.04% in 2006 to 0.12% in 2015. Factors associated with a higher likelihood of AKI during pregnancy included older age, black and Native American race/ethnicity and diabetes. Hospitalizations with pregnancy-related AKI had a 14-fold higher adjusted risk of inpatient mortality and a 16-fold higher adjusted risk of cardiovascular events. What should readers take away from your report?

Response: Our findings suggest high burden of AKI during pregnancy in women especially those with history of diabetes and of Black and Native American race/ethnicity. Our study further considered patients with all pregnancy-related hospitalizations, thus avoiding the potential shortfalls of registries dependent on voluntary reporting or patient recall. We speculate that increased awareness and detection of AKI during pregnancy have contributed to the finding of increasing rates of AKI during pregnancy-related hospitalizations in the recent years in the United States, but further research is needed. I encourage clinicians to routinely check kidney panel during inpatient hospitalizations. AKI during pregnancy is associated with higher risks of mortality and higher risk of cardiovascular events. What recommendations do you have for future research as a result of this work?

Response: Future research should focus on implementation of specific interventions for the prevention, diagnosis, and management of AKI in pregnant women may reduce the burden of AKI during hospitalizations in the United States. Is there anything else you would like to add?

Response: I would like to thank my entire team at the University of Cincinnati who participated in the project. The research was supported by intramural funds of Division of Nephrology, Kidney C.A.R.E (Clinical Advancement, Research and Education) Program, University of Cincinnati. The authors have no disclosures. 


Shah S, Meganathan K, Christianson AL, Harrison K, Leonard AC, Thakar CV. Pregnancy-Related Acute Kidney Injury in the United States: Clinical Outcomes and Health Care Utilization. Am J Nephrol. 2020;51(3):216–226. doi:10.1159/000505894 


Mar 30, 2020 @ 8:32 pm

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