PURPOSE:
Pregnancy-associated Acute Kidney Injury (PrAKI) is a life-threatening but under-recognised complication of pregnancy. Despite being associated with significant maternal and neonatal morbidity, it remains poorly understood, under-diagnosed, and largely excluded from mainstream obstetric and nephrology research. This is compounded by a lack of pregnancy-specific diagnostic thresholds, limited availability of renal biomarkers in routine care, and the historical exclusion of pregnant women from clinical studies.

DISCUSSION:
The Global PrAKI Consortium is a midwifery-led, international initiative established to address these critical gaps. Anchored in principles of equity, collaboration and implementation science, the Consortium aims to strengthen early identification and management of PrAKI through high-quality research, context-appropriate diagnostic innovation, and inclusive education. Midwifery leadership is central to this agenda, recognising the profession’s unique role in antenatal, intrapartum and postpartum care, and its potential to drive earlier recognition and response. The Consortium's multi-disciplinary membership includes midwives, obstetricians, nephrologists, nurses, obstetric physicians, public health specialists and more. The Consortium and embedded Academy co-develop implementation research and education strategies that are applicable in all settings. The current primary targets are the development and dissemination of a Global PrAKI Toolkit, designed to be practical, culturally sensitive and midwife-led. This includes validation of gestation-specific reference values for serum creatinine, and feasibility testing of point-of-care creatinine devices in routine maternity care.

EVIDENCE WHERE RELEVANT:
The Global Midwifery Accelerator is designed to strengthen midwifery leadership, education and workforce capacity. The World Health Assembly adopted a resolution recognising kidney disease as a global public health priority, preventing avoidable PrAKI and facilitating early action in midwifery care models aligns with both of these global drivers.

KEY MESSAGE:
Already uniting over 120 global experts across disciplines and regions, the Consortium exemplifies midwifery leadership in global health systems strengthening. Our work demonstrates that investment in midwife-led, evidence-informed, and community-responsive strategies is essential to reduce avoidable harm and improve maternal kidney outcome Complications - other