Evidence map›Paper›PMID 36635580›Full record

ArticleJournal of nephrology2023

Ethnic disparities in pregnancy-related acute kidney injury in a United Kingdom population.

Rouvick M Gama, Mahua Bhaduri, William Atkins, Miss Kelly Nwankiti, Gemma Hutchison, Mica Thomas, Katherine Clark, Clare B Kelly, Kathryn V Dalrymple, Royce P Vincent and 2 more

Abstract read
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Article in Journal of nephrology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Rouvick M GamaKing's Kidney Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK. rouvick.gama@nhs.net.ORCID http://orcid.org/0000-0003-0292-7582
Mahua BhaduriKing's Fertility Unit, Fetal Medicine Research Institute, Windsor Walk, Denmark Hill, London, UK.
William AtkinsKing's Kidney Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Miss Kelly NwankitiDepartment of Haematology, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Gemma HutchisonDepartment of Obstetrics, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Mica ThomasDepartment of Obstetrics, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Katherine ClarkDepartment of Females and Children's Health, School of Life Course Sciences, King's College London, London, UK.
Clare B KellyCentre of Public Health, Queen's University, Belfast, UK.
Kathryn V DalrymplePopulation Health Sciences, School of Life Course and Population Sciences, King's College London, London, UK.
Royce P VincentDepartment of Clinical Biochemistry, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Nick KametasHarris Birthright Centre, Fetal Medicine Research Institute, Windsor Walk, Denmark Hill, London, UK.
Kate BramhamKing's Kidney Care, King's College Hospital NHS Foundation Trust, Denmark Hill, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe incidence of acute kidney injury in pregnancy (P-AKI) is rising and is associated with detrimental maternal and foetal outcomes. Ethnic disparities in pregnancy outcomes are well recognized, with females who identify as Black or Asian being more likely to die during pregnancy compared to females who identify as White ethnicity.

methodsThis study reports rates of P-AKI and associated risk factors in pregnant females of different ethnicities. All pregnancies were recorded between 2016 and 2020. AKI episodes were identified using electronic alerts. Ethnicity, AKI stage (1-3), obstetric outcomes and risk factors for P-AKI (chronic hypertension, pregnancy-induced hypertension and pre-eclampsia, and haemorrhage) were assessed.

resultsThere were 649 P-AKI episodes from 16,943 deliveries (3.8%). Black females were more likely to have P-AKI (5.72%) compared to those who were White (3.12%), Asian (3.74%), mixed ethnicity (2.89%) and Other/Not Stated (3.10%). Black females, compared to White females, were at greater risk of developing P-AKI if they had haemorrhage requiring blood transfusion (OR 2.44, 95% CI 1.31,4.54; p < 0.001) or pregnancy-induced hypertension (OR 1.79, 95% CI 1.12, 2.86; p < 0.001). After adjusting for risk factors, Black females had increased risk of developing P-AKI (OR 1.52, 95% CI 1.22, 1.80; p < 0.001) compared to White females. Black females were at increased risk of developing P-AKI compared to White females. Mode of delivery, pregnancy-induced hypertension and haemorrhage are likely to have contributed. The increased risk persists despite accounting for these variables, suggesting that other factors such as socioeconomic disparities need to be considered.

conclusionsThe incidence of P-AKI is likely higher than previously stated in the literature. However, caution must be exercised, particularly with AKI stage 1, as the KDIGO system is not validated in pregnancy and gestational changes in renal physiology need to be considered. Pregnancy-specific AKI definitions are needed.

Indexed as

Acute Kidney InjuryHypertension, Pregnancy-InducedPre-EclampsiaEthnicityFemaleHumansPregnancyPregnancy OutcomeAcute kidney injuryEthnicityPregnancy

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.