article · BMC Nephrology
A study at Muhimbili National Hospital in Tanzania examined the clinical features and hospital outcomes of 112 pregnant and postpartum women with acute kidney injury requiring haemodialysis between 2022 and 2024. The patients had an average age of 31.3 years, and nearly all were transferred from lower-level healthcare facilities. Over half presented with stage three kidney injury, with hypertensive disorders identified as the primary obstetric cause. A large majority needed critical care admission, and over forty percent required mechanical ventilation. The in-hospital mortality rate was 17.9 percent. Furthermore, two-thirds of the surviving patients were lost to follow-up within three months of discharge, demonstrating substantial difficulties in ongoing outpatient monitoring.
Pregnancy-related kidney failure is a life-threatening complication that heavily impacts maternal health in low-resource settings. This research highlights critical bottlenecks in patient care, showing that late referrals, severe illness at admission, and poor post-discharge follow-up contribute to significant mortality. Addressing these challenges is vital for improving maternal survival rates and strengthening healthcare delivery systems.
The abstract does not indicate a direct commercialisation pathway, as it focuses on clinical outcomes and hospital data. However, the findings highlight operational needs for medical device developers and healthcare providers, particularly in creating affordable diagnostic tools for early detection of kidney injury in primary clinics, as well as digital patient-tracking systems to reduce the high rate of postpartum follow-up loss.
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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.
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DOI: 10.1186/s12882-025-04519-z
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