The Complete Resolution Of Pregnancy-Related Acute Kidney Injury In An Eclampsia Patient Complicated By HELLP Syndrome: A Case Report

Abstract

Pregnancy-related acute kidney injury (PrAKI) is a significant cause of maternal and fetal morbidity, particularly when complicated by eclampsia and HELLP syndrome. We report a 34-year-old woman in her second pregnancy with seizures, anuria, severe thrombocytopenia, markedly elevated liver enzymes, and intrauterine fetal death at approximately 31–32 weeks of gestation. Laboratory findings confirmed PrAKI alongside eclampsia, HELLP syndrome, pneumonia, and gestational diabetes mellitus. Despite initial fluid management and diuretic therapy, anuria and rising serum creatinine persisted, necessitating hemodialysis initiation on the second day. A total of six hemodialysis sessions were completed, after which kidney function gradually recovered. The hemodialysis was then discontinued due to her significant renal improvement with stable clinical and metabolic parameters within approximately two months, consistent with KDIGO 2012 recommendation to discontinue RRT when intrinsic kidney function has recovered sufficiently to meet patient needs. As the conclusion, the fundamental aspect of PrAKI management is supportive care to maintain renal perfusion.