Nuttha LumlertgulRolando Claure‐Del GranadoAnjali AcharyaGhada AnkawiSwarnalata GowrishankarClaudio RoncoRavindra L. MehtaCatherine Nelson‐PiercyMarlies OstermannCatherine Nelson‐Piercy2026-03-222026-03-22202510.1093/ndt/gfaf226https://doi.org/10.1093/ndt/gfaf226https://andeanlibrary.org/handle/123456789/78183Despite advancements in obstetric care, pregnancy-associated acute kidney injury (PrAKI) continues to be a significant public health concern, contributing to substantial maternal and fetal morbidity and mortality. The most common causes of PrAKI include preeclampsia/eclampsia, haemorrhage, and infection. Diagnosis is influenced by gestational age and individual risk factors. Alongside traditional investigations such as imaging and kidney biopsy, novel diagnostics and biomarkers may provide valuable insights for differential diagnosis. This review aims to offer an update on the diagnostic approaches and investigational tools for PrAKI, while also addressing current challenges in the diagnostic paradigm and presenting recommendations for clinical practice and future research.enMedicineIntensive care medicineClinical PracticeDiagnostic testKidney diseaseAcute kidney injuryMEDLINEPublic healthDiagnostic accuracyMedical physicsarticle