To explore the change and its significance of serum interleukin-22 (IL-22), hydrogen sulfide (H₂S), and osteoprotegerin (OPG) levels in patients with hypertensive disorders of pregnancy (HDP) complicated with acute kidney injury (AKI).

From May 2020 to December 2021 in the department of obstetrics of the hospital, 50 patients with HDP were selected as HDP group, and 50 HDP patients complicated with AKI were selected as HDP-AKI group, while 50 healthy pregnant women were selected as control group. The enzyme-linked immunosorbent assay (ELISA) method was used to measure the levels of serum IL-22, H₂S, OPG, creatinine, blood urea nitrogen, and urine protein. The Pearson method was applied to analyze the correlation among IL-22, H₂S, and OPG. Logistic regression analysis was performed to screen the influencing factors in the outcomes of the HDP patients complicated with AKI.

Compared with the control group, the HDP group showed higher levels of serum IL-22, OPG, serum creatinine, and blood urea nitrogen as well as urinary protein, but showed lower level of H₂S (P<0.05). Compared with the HDP group, the HDP-AKI group also had higher levels of IL-22, OPG, creatinine, and blood urea nitrogen as well as urinary protein, but had lower level of H₂S (p<0.05). In the HDP-AKI group, IL-22 was positively correlated with OPG (r=0.386, P<0.001), while IL-22 was negatively correlated with H₂S (r=-0.306, P<0.001), and OPG was also negatively correlated with H₂S (r=-0.312, P<0.001). Age, body mass index (BMI), serum H₂S, IL-22, OPG, serum creatinine, and blood urea nitrogen as well as urinary protein were all influencing factors in the pregnancy outcome of HDP patients complicated with AKI (P<0.05).

The HDP patients complicated with AKI had higher levels of serum IL-22 and OPG, but lower level of H₂S, which might have a certain impact on the pregnancy outcomes.