Abstract: Objective To investigate the clinical features and significance of KDIGO-AKI grading standard in
the treatment of acute fatty liver of pregnancy (AFLP) complicated with acute renal injury (AKI). Methods
Total of 54 patients with AFLP in Beijing Ditan Hospital, Capital Medical University from January 1996 to
March 2014 were selected. The clinical characteristics of AFLP patients with AKI were analyzed according to
KDIGO-AKI staging retrospectively. Results Total of 41 AFLP patients with AKI were enrolled. The average
age of onset was (27.8 ± 3.9) years old and the gestational age was (35.5 ± 2.8) weeks. The average period of
hospital stay was (25.6 ± 21.8) days (1～120 days). Among the 41 AFLP patients with AKI, 16 cases (39.0%)
were AKI grade 1, 14 cases (34.1%) were AKI grade 2 and 11 cases (26.8%) were AKI grade 3. A total of 12
cases (29.2%) underwent renal replacement therapy, among whom 3 cases were AKI grade 2 and 8 cases were
AKI grade 3. The beginning time of continuous renal replacement therapy (CRRT) was 1～4 days [(2.2 ± 1.4)
days] after delivery, and the ending time was 3～10 days [(5.5 ± 2.6) days] after delivery. Blood purification
time was 12～144 hours [(81.8 ± 48.4) hours]. The creatinine levels of patients with renal replacement
therapy were 191～522 μmol/L [(337.8 ± 106.9) μmol/L] at the beginning. Total of 19 patients were enrolled
in follow-up study, the liver and kidney functions of all patients were normal. Conclusions AKI is a common
complication of AFLP and most patients do not need renal replacement therapy. After recovery, the function
of renal could return to normal.