Obstetric Complications Leading to Acute Renal Failure: Insights into Management Challenges

Abstract

Acute Renal Failure (ARF) during pregnancy poses a formidable challenge to healthcare practitioners, demanding a profound understanding of the intricate interplay between renal physiology and the unique physiological changes inherent to gestation. This chapter endeavors to unravel the complexities surrounding ARF in the pregnant population, providing a comprehensive overview. The physiological alterations of ARF explored the hemodynamic changes, alterations in glomerular filtration rate, and hormonal influences, providing a foundation for comprehending the unique challenges posed by renal failure in the pregnant population. The incidence of AKI in pregnancy (P-AKI) has markedly decreased over the last three decades in India, particularly due to decreased incidence of postabortion AKI. However, P-AKI still accounts for 3%–5% of cases of total AKI. Postabortion sepsis has decreased to between 0.9% and 1.5% in 2014 from 9.4% in 1980– 1990 in the new millennium. A multidisciplinary approach involving obstetricians, nephrologists, and other specialists is often necessary to address the complex nature of ARF in pregnancy and to ensure the best possible outcomes for both the mother and the developing fetus.