Online Resource 1. Patients with KI Detected During the Course of Pregnancy: Comorbid
Online Resource 1. Patients With KI Detected During the Course of Pregnancy: Comorbid Conditions and Clinical Characteristics
Age, y/GxPx / Preexisting Conditions and Pregnancy-Related Diseases / Timing of KI, trimester / sCr, mg/dLB / At KI
20/G1P0 / Kidney transplant / 2 / 0.9 / 1.2a
24/G1P0 / GDM; surgically repaired congenital ectopic ureterocele; recurrent UTI / 3 / 0.5 / 0.8
36/G1P0 / Surgical bilateral ureteral reimplantation with continued chronic retrograde reflux; multiple episodes of pyelonephritis; percutaneous nephrostomy tube placement at 34 weeks’ gestation; severe anemia that required blood transfusions / 3 / 0.6 / 1.0
25/G2P1 / Liver transplant; UC (taking corticosteroids); severe PRECL; -streptococcal bacteriuria / 3 / 0.6 / 1.1
Abbreviations: B, baseline; GDM, gestational diabetes; GxPx, gravida, para; KI, kidney injury; PRECL, preeclampsia; sCr, serum creatinine; UC, ulcerative colitis; UTI, urinary tract infection.
a sCr remained permanently at 1.2-1.3 mg/dL.
Supplementary material for Kidney Injury During Pregnancy: Associated Comorbid Conditions and Outcomes. Submitted for consideration of publication to Archives of Gynecology and Obstetrics.
Online Resource 2. Patients With KI Diagnosed in the Immediate Peripartum Period: Comorbid Conditions and Clinical Characteristics
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
20/G1P0/V / Chorioamnionitis (gentamicin) / NAB / 0.5 / 0.9
21/G1P0/C / Polycystic kidney disease; congenital hepatic fibrosis / NAB, ↓BP, EPH, IB / 1.3 / 1.9
37/G5P2/V / ITP (taking corticosteroids) / NAB, PLT, IB / 0.5 / 0.8
21/G1P0/V / Thin membrane nephropathy; cholestasis of pregnancy; -streptococcal bacteriuria / NAB, IB / 0.5 / 0.8
27/G1P0/V / Heterozygous for factor V Leiden mutation (taking aspirin) / NAB, IB / 0.6 / 0.9
16/G1P0/V / None / NAB, IB / 0.7 / 1.0
25/G2P0/C / Pneumonia (gentamicin) / NAB, EPHa, KET, IB / 0.7 / 1.1
38/G2P0/V / Twin gestation; HELLP syndrome / NAB, EPH, ↓BP / 0.6 / 1.4
29/G1P0/V / Gestational HTN; -streptococcal bacteriuria / NAB, IB / 0.6 / 0.9
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
27/G3P1/V / Placental abruption; subchorionic hemorrhage / No labor analgesia used, IB / 0.4 / 0.7
28/G4P1/V / Ulcerative colitis (mesalamine + corticosteroids) / NAB, IB / 0.4 / 0.7
27/G2P0/Cb / Chorioamnionitis (gentamicin); PPC: surgical wound infection (vancomycin + gentamicin + clindamycin) / NAB, EPHa, KET, IB / 0.8 / 1.4
35/G5P4/Cb / Polycystic kidney disease; PRECL; obesity / NAB, KET, IB / 0.8 / 1.1
25/G2P0/Cb / Chronic HTN; obesity / NAB, EPHa, KET, IB / 0.6 / 0.9
32/G2P2/Cb / PRECL; obesity / NAB, EPHa, IB / 0.5 / 0.8
32/G3P2/Cb / Placenta previa; obesity; PPC: hypovolemic shock; outcome: acute renal failure (sCr 7.0 mg/dL on 9th postdelivery day); resolved by 6 mo post partum / GA, EPH, PHEN, DOPA-EPI-Norep, ↓BP, ↓SpO2, 15 L fluids, RBCs, PLT, FFP / 0.7 / 1.3
40/G3P1/Cb / Obesity / NAB, KET, IB / 0.5 / 0.8
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
37/G1P0/V / Chronic HTN; obesity / NAB, IB / 0.6 / 0.9
33/G2P1/Cb / HELLP syndrome; GDM / NAB, EPHa, KET, IB / 0.6 / 1.0
23/G3P0/C / Ulcerative colitis (taking mesalamine + corticosteroids) / NAB+GA, KET, IB / 0.5 / 0.8
25/G1P0/C / GDM; obesity / NAB, EPHa, KET, IB / 0.5 / 1.0
34/G9P1/Cb / None / GA, KET, IB / 0.7 / 1.0
29/G2P1/Cb / Obesity / NAB, KET, IB / 0.5 / 0.8
39/G4P2/V / HELLP syndrome / NAB, IB / 0.4 / 0.8
22/G1P0/V / PRECL with previous pregnancy / NAB, EPHa, IB / 0.5 / 1.0
21/G3P0/V / PRECL with previous pregnancy / NAB, IB / 0.7 / 1.0
23/G3P1/V / PPC: postpartum eclampsia with HTN and seizures resulting in posterior reversible encephalopathy syndrome / NAB, IB / 0.7 / 1.1
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
25/G1P0/C / Kidney transplant; chronic HTN; emphysematous pyelonephritis / NAB+GA, EPH, PHEN / 1.2 / 1.5
34/G2P0/V / Twin gestation; PRECL; PPC: delayed hemorrhage 1 wk after delivery (retained placenta) / NAB, EPHa / 0.7 / 2.4
33/G2P1/V / Kidney transplant; chronic HTN; PRECL; GDM; subsequent renal transplant 18 months after delivery / NAB / 2.3 / 4.0
20/G2P0/V / HELLP syndrome (atypical); PPC: uterine hematoma 3 h after delivery / NAB, PHEN, ↓BP / 1.8 / 2.3
23/G2P0/C / DM; PRECL; chorioamnionitis (nitrofurantoin) / NAB, PHEN / 0.6 / 1.2
23/G1P0/C / DM; severe PRECL; -streptococcal bacteriuria (clindamycin); chorioamnionitis (gentamicin) / NAB, EPHa / 0.7 / 1.3
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
30/G1P0/V / CHD and CVA after cardiac surgery at age 1 y; severe PRECL; large subchorionic bleed; PROM at 33 wk resulting in induced delivery / NAB, IB / 0.6 / 1.0
25/G2P0/C / Prior partial nephroureterectomy; bilateral ureteroneocystostomy; frequent UTIs; HELLP syndrome; colonic obstruction (retroverted uterus) at 27 wk (colonoscopy with decompression); gentamicin given peripartum; PPC: intra-abdominal abscess postpartum, surgically drained / GA, RBCs, KET, IB / 0.9 / 1.4
23/G1P0/C / Obesity; DM; UTI (gentamicin); metabolic acidosis, ↑ liver enzymes at 36 wk / NAB, EPH, PHEN, KET, IB / 0.9 / 1.4
21/G1P0/V / Severe PRECL; -streptococcal bacteriuria / NAB, IB / 0.7 / 1.0
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
34/G1P0/V / Obesity; gestational HTN / NAB, IB / 0.6 / 0.9
33/G1P0/V / Twin gestation; HELLP syndrome (atypical); PPC: retained placenta (gentamicin + clindamycin) / NAB, IB / 0.9 / 1.5
25/G4P2/C / Chronic HTN; chorioamnionitis (gentamicin, clindamycin); placental abruption; PPC: 2 wk after delivery, episode of HTN (possibly related to thyrotoxicosis) and intra-abdominal pelvic infection (piperacillin + tazobactam + vancomycin) / NAB / 0.5 / 0.9
41/G1P0/V / Gestational HTN; PPC: postpartum hemorrhage / NAB, RBCs, IB / 0.5 / 1.5
18/G1P0/C / HELLP syndrome (atypical) / NAB / 0.5 / 0.9
32/G4P1/V / Severe PRECL / NAB / 0.9 / 1.3
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
38/G4P3/C / Chronic HTN (nifedipine, labetalol); PRECL in previous pregnancies / NAB, EPHa, KET, IB / 0.7 / 1.0
25/G1P0/C / Severe PRECL; -streptococcal bacteriuria / NAB, EPHa, KET, IB / 0.4 / 0.7
25/G2P0/C / No comorbid conditions; 5 d of dyspnea; home amoxicillin, but no improvement; admitted for severe dyspnea; SpO2 82%; bilateral opacities on chest radiograph (pneumonia?); final diagnosis, “ARDS of unknown cause” + encephalopathy; treated with vancomycin + azithromycin; intubated before delivery / GA, RBCs, IB / 0.5 / 1.2
Online Resource 2 (continued)
Age, y/GxPx/
Type of Delivery / Preexisting Conditions, Pregnancy-Related Diseases, and Peripartum Complications / Anesthesia/Analgesia, Hemodynamic Stability, Blood Products Given, and Peripartum NSAIDs / sCr, mg/dL
B / At KI
34/G2P1/V / PPC: 10 d after delivery, intra-abdominal abscess required laparotomy; positive for Streptococcus viridans and Enterococcus (piperacillin + tazobactam) / NAB, KET, IB / 0.6 / 0.9
32/G3P1/C / Twin gestation; severe PRECL; -streptococcal bacteriuria; PPC: hemorrhage in PACU (1 L blood loss); cardiac arrest; ICU admission / NAB, RBCs, PLT, FFP / 0.9 / 1.5
29/G1P0/V / Kidney transplant; gestational HTN / NAB / 1.3 / 1.6
21/G1P0/V / Obesity; cholestasis of pregnancy / NAB / 0.7 / 1.1
Abbreviations: ARDS, acute respiratory distress syndrome; B, baseline; ↓BP, hypotension, defined as systolic blood pressure 80 mm Hg; C, cesarean delivery; CHD, congenital heart disease; CVA, cardiovascular accident; DM, diabetes mellitus; DOPA, dopamine; EPH, ephedrine; EPI, epinephrine; FFP, fresh frozen plasma; GA, general anesthesia; GDM, gestational diabetes; GxPx, gravida, para; HTN, hypertension; IB, ibuprofen; ICU, intensive care
Online Resource 2 (continued)
unit; ITP, idiopathic thrombocytopenic purpura; KET, ketorolac; KI, kidney injury; NAB, neuroaxial anesthesia block; Norep, norepinephrine; NSAID, nonsteroidal antiinflammatory drug; PACU, postanesthesia care unit; PHEN, phenylephrine; PLT, platelets; PPC, postpartum complication; PRECL, preeclampsia; PROM, premature rupture of membranes; RBC, red blood cell; sCr, serum creatinine; ↓SpO2, hypoxemia, defined as an oxyhemoglobin saturation <90%; UTI, urinary tract infection; V, normal vaginal delivery.
a Received repeated doses of ephedrine during delivery, but the systolic blood pressure did not decrease below 80 mm Hg.
b Repeat cesarean delivery.
Supplementary material for Kidney Injury During Pregnancy: Associated Comorbid Conditions and Outcomes. Submitted for consideration of publication to Archives of Gynecology and Obstetrics.