Acute kidney injury in pregnant women with decompensated liver cirrhosis, an uncommon but dangerous condition: a lesson for the clinical nephrologist

Abstract

The cases Patient #1A 30-year-old primigravida in septic shock, who had been diagnosed with autoimmune hepatitis and liver cirrhosis (Child-Pugh score 7) 2 years earlier, maintained on prednisone (15 mg/d) and azathioprine (100 mg/d), was referred to our tertiary care hospital two days after delivering a stillborn baby (25 gestational weeks) following prelabour preterm rupture of the membranes (PPROM).A comprehensive history taken from her family revealed that she had tried to become pregnant for 6 years and once pregnant, had not sought regular antenatal care.On physical examination, the patient was febrile (38.7 °C) and had jaundice and low blood pressure (88/50 mmHg).Her serum creatinine was 1.6 mg/dL; her urine output was 300 ml on the day of presentation, after which she became anuric.Laboratory data, ultrasounds and treatment are summarised in Table 1.The patient was admitted to the intensive care unit (ICU), where her condition rapidly deteriorated, and she died two days later.