Our members are working hard to generate the evidence: here are some of our recent publications
Assessment of point-of-care creatinine testing in pregnancy: a prospective cohort study in Sierra Leone.
Kuhrt, K et al. May 2026. The Lancet Regional Health Africa. DOI: 10.1016/j.lanafr.2026.100069
The paper describes the incidence, resolution and clinical consequences of presumed PrAKI or kidney https://www.praki.org/wp-content/uploads/2026/05ysfunction among high-risk pregnant and postpartum women, to assess feasibility of POC-Cr testing.
A global Consortium for pregnancy-associated acute kidney injury
Clark K et al. January 2026. The Lancet Obstetrics, Gynaecology & Women’s Health. DOI: 10.1016/S3050-5038(26)00007-5
The paper describes the founding of the Global PrAKI Consortium at an international stakeholder workshop in Nairobi, Kenya in July 2025. Forty-one participants from 14 countries co-developed four key outputs: a comprehensive PrAKI Toolkit; a protocol for a global snapshot study; the launch of the Global PrAKI Academy; and a set of research priorities across six areas.
Impact of Preeclampsia on Long-Term Kidney Function in a Low-Resourced Setting
Davidson B et al. February 2026. Kidney International Reports. DOI: 10.1016/j.ekir.2025.11.014
A prospective cohort study from Groote Schuur Hospital, South Africa, following 241 women with preeclampsia for up to two years. Half had concurrent PrAKI. Persistent hypertension was found in 44–47% at follow-up, reduced kidney function in 20%, and albuminuria in over 50%. Integrated postpartum surveillance is urgently needed, particularly in low-resource settings.
Assessment of Point-of-care Creatinine testing In Pregnancy: a prospective cohort study in Sierra Leone
Kuhrt K et al. October 2025. The Lancet. DOI: 10.2139/ssrn.5543310 (full publication details to be confirmed)
A prospective observational study in Sierra Leone evaluating whether point-of-care creatinine testing is feasible and accurate in pregnant and postpartum women at high risk of PrAKI, in a setting where laboratory creatinine testing is often unavailable.
Pregnancy-associated acute kidney injury: consensus report of the 32nd Acute Disease Quality Initiative workgroup
Nelson-Piercy C et al. July 2025. Nature Reviews Nephrology. DOI: 10.1038/s41581-025-00979-6
The first international expert consensus on PrAKI. The report defines PrAKI as a driver of health inequity worldwide and sets out recommendations on causes, diagnosis, management and follow-up. Consortium members Kate Bramham, Katherine Clark, Rolando Claure, Valerie Luyckx, Rasha Shemies, Lizemarie Wium and Poli de Figueiredo are among the authors.
Women and kidney health: conclusions from a KDIGO Controversies Conference
Piccoli GB et al. May 2025. Kidney International. DOI: 10.1016/j.kint.2025.02.021
The KDIGO Controversies Conference on Women and Kidney Health concluded that sex and gender must be integrated into all aspects of kidney care. CKD was identified as a risk factor for adverse pregnancy outcomes across all kidney disease types, and PrAKI was highlighted as a key unmet need.
Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review
Shalaby A, Shemies R. January 2022. Journal of Nephrology. DOI: 10.1007/s40620-022-01349-2
A systematic review of the clinical profile and outcomes of PrAKI across Africa. High rates of dialysis dependence and maternal mortality, with hypertensive disorders and sepsis as dominant causes. Co-authored by Consortium member Rasha Shemies.
Pregnancy-Associated Acute Kidney Injury in Low-Resource Settings: Progress Over the Last Decade
Davidson B et al. September 2022. Seminars in Nephrology.
A review of PrAKI in low-resource settings across Africa, Latin America and Asia. Incidence in LMICs is 4–26%, compared with 1–2.8% in high-income settings. Dialysis dependence after PrAKI can be a death sentence in settings with limited kidney replacement therapy.
Incidence of pregnancy-associated acute kidney injury in low- and middle-income countries: a meta-analysis
Tran P et al. August 2025. Bulletin of the World Health Organization. DOI: 10.2471/BLT.24.293077
A meta-analysis covering 424,081 pregnancies across 15 LMICs. Pooled incidence was 91 per 10,000 pregnancies, rising to 254 per 10,000 in the WHO African Region. PrAKI was associated with an 18.8-fold higher odds of maternal death and 29.8% neonatal death or stillbirth.
Pregnancy-associated acute kidney injury as an important driver of chronic kidney disease in developing countries: A systematic review
Meena P et al. August 2025. Maternal Health, Neonatology and Perinatology. DOI: 10.1186/s40748-025-00224-9
A systematic review of 25 studies from India covering 2,306 women with PrAKI. CKD developed in 12.8–35% of survivors, and up to 30% remained dialysis-dependent at follow-up. Co-authored by Consortium member Priti Meena.
Temporal trends and clinical characteristics associated with pregnancy-related acute kidney injury in England: a population-based cohort study
Leal M et al. April 2025. AJOG Global Reports. DOI: 10.1016/j.xagr.2025.100493
Incidence of pregnancy-related AKI in England increased from 2.9 per 10,000 pregnancies in 1998–2002 to 11.2 per 10,000 in 2013–2017 — a near four-fold rise. PrAKI is not only a low-income country problem. Co-authored by Consortium member Kate Bramham.
Other people are working hard in this space too
Kontomanolis EN et al. August 2025. Journal of Clinical Medicine. DOI: 10.3390/jcm14176031
Pregnancy itself increases the risk of AKI by 51%. Pre-eclampsia, eclampsia and HELLP syndrome are the leading drivers. PrAKI is associated with significantly worse maternal and fetal outcomes compared with the general obstetric population.
Prevalence and trends of pregnancy-related acute kidney injury in sub-Saharan Africa: a systematic review and meta-analysis
Jalo R et al. December 2024. Journal of Nephrology.
A systematic review and meta-analysis across 13 studies covering 5,273 individuals in sub-Saharan Africa. Documents the high and persistent burden of PrAKI in the region and calls for greater investment in data collection and standardised definitions.
Long-term risks of adverse kidney outcomes after acute kidney injury: a systematic review and meta-analysis
Veltkamp F et al. May 2025. Nephrology Dialysis Transplantation. DOI: 10.1093/ndt/gfaf093
A meta-analysis of 70 studies covering over 1.8 million individuals. Those with AKI had a 2.4-fold higher risk of CKD and a 2.6-fold higher risk of kidney failure. Even stage 1 AKI of shortest duration remained at elevated risk — directly relevant to the case for postnatal kidney review after PrAKI.
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