(1098) Pregnancy related acute kidney injury leads to chronic kidney disease in the postpartum

Objective: Rates of Pregnancy Related-Acute Kidney Injury (PR-AKI) and hospitalizations due to PR-AKI have increased in the past two decades in the United States. Acute kidney injury (AKI) outside the context of pregnancy has been associated to the progression of chronic kidney disease (CKD). This study has two objectives. The first is to test the hypothesis that PR-AKI leads to the development CKD (Study 1). The second is to test the hypothesis that treatment of AST-120, oral carbon absorbent of uremic toxin precursor, will slow the development of CKD in rats following PR-AKI (Study 2).

Study Design: Time pregnant Sprague Dawley rats arrive on gestational day (GD) 11, and PR-AKI is induced on GD18 via a 45-min bilateral renal ischemic reperfusion surgery. Animals are allowed to delivered without intervention on GDs 21-22. Throughout the study, animals had their urine collected via metabolic cages. These measurements were collected at the following timepoints: GD15. GD19, Postpartum week (PPW 1), PPW5, PPW9, PPW12, and PPW16. Urinary protein and creatinine were measured via commercially bought assays. For the second objective, animals followed a similar time course with the exception that AST-120 treatment began on PPW2 until PPW11.

Results: Study 1 results urine output is decreased in PR-AKI animals at GD19, PPW1 and at PPW16 compared to normal pregnant (NP). In addition, urinary protein was increased at GD19, PPW1, and PPW16. Compared to NP, at PPW12 and PPW16 PR-AKI animals had a decrease in NP. Study 2 results showed that AST-120 treatment improved urine output at PPW16 compared in PR-AKI animals compared to untreated PR-AKI animals. AST-120 treatment decreased urinary protein in PR-AKI animals at PPW16. AST-120 treatment doesn’t affect urinary creatinine values at PPW16.

Conclusion: PR-AKI led to evidence of long-term effects of renal damage through decreased urine output, increased urinary protein, and decreased urinary creatinine. AST-120 was able to improve 2 of 3 outcomes by increasing urine output and decreasing urinary protein.