We very often see patients in our ward, post partum AKI females, and majority of them on kidney biopsy come as acute cortical necrosis; complete or partial. But in many of these cases, the patient becomes non-oliguric and dialysis free after 4-6 months time. How should one analyze and interpret such cases?Because although they end up as CKD, being off Maintenance HD is a great blessing for these females.
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AKI due to total or partial acute cortical necrosis post partum is becoming rare in developed countries. However, it is still occuring in developing countries due to obstetric complications such as abruptio placentae, septic abortion, eclampsia, post partum hemorrhage and puerperal sepsis. It is caused by intense cortical ischemia with or without vascular thrombosis. Often, it is accompanied by potentially reversible injuries such as endotheliosis and ATN which may explain the partial renal function recovery. Also, an old report described 20-40% recovery from post partum acute tubular necrosis. Although, extense or total cortical necrosis cases rarely recover in our experience.The reply is currently minimized
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