Pregnancy-related acute kidney injury (AKI) may be associated with significant morbidity and mortality in young and often otherwise healthy women. We conducted a retrospective cohort study of all consecutive pregnancies between 1997 and 2011 in Ontario and describe the incidence, characteristics, and outcomes of AKI treated with dialysis (AKI-D) during pregnancy or within 12 weeks postpartum. Of 1,918,789 pregnancies, 188 were complicated by AKI-D (incidence proportion: 1 per 10,000, 95% confidence interval 0.8 to 1.1). Eight women died (4.3% versus 0.01% in the general population) and seven (3.9%) survivors remained dialysis-dependent four months after delivery. The presence of AKI-D was associated with several maternal complications as well as low birth weight, small for gestational age, and preterm birth among infants, although there were no stillbirths and fewer than five neonatal deaths in affected pregnancies. In conclusion, AKI-D in pregnancy is rare. Most affected women and their babies have good short-term outcomes
