Acute renal failure during the pregnancy: A review on pathophysiology, risk factors and management

Abstract

Acute renal failure (ARF) is a major medical problem during pregnancy with maternal and fetal outcomes. While the trend of pregnancy-related ARF is on a decline due to the advances in obstetrics care and the legality of abortion among developed countries, this situation remains one of the serious health problems in the developing nations. This review aims to evaluate the current studies with regards to pregnancy related ARF pathophysiology, risk factors and treatment. PubMed, Embase, Scopus and directory of open access journals (DOAJ) databases were searched to obtain the information. Most of the studies in this review were conducted in observational, both prospective and retrospective studies. Results demonstrated a variety of major pregnancy-related ARF causes including obstetric hemorrhage, hypertensive disorders in pregnancy, sepsis, thrombotic microangiopathy and acute fatty liver in pregnancy. Aside from awareness of the pathogenesis of pregnancy-related ARF and its risk factors, understanding the physiological renal adaptation during pregnancy is essential for early detection, diagnosis, and proper management to prevent the pregnancy related complications.