Pregnancy Related Acute Kidney Injury; Our Experience at Tertiary Level Hospital
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 4
Abstract
Introduction: Pregnancy-related acute kidney injury (AKI) is a common occurrence and is associated with substantial maternal morbidity and mortality in developing countries. It may comprise up to 25% of the referrals to dialysis centers in developing countries. Acute kidney injury in pregnancy bears a high risk of bilateral renal cortical necrosis and consequently chronic renal failure. Study aimed to evaluate the contributing factors responsible for pregnancy-related Acute kidney injury and to assess the outcome of patients with pregnancy-related Acute kidney injury. Material and methods: The present study is a prospective study of patients with obstetric complications leading to Acute kidney injury admitted in Obs and Gynae Deptt and nephrology deptt of IGIMS for a period of one year. Pregnant women who are included in the study are those who were healthy previously and had developed Acute kidney injury - oliguria (Urine output <400 ml/d) and azotemia (Serum creatinine >2 mg%) due to pregnancy related complications. Results: Pregnancy related complications was present in 38 patients admitted in our hospital with acute kidney injury in one year period. Out of these 37% (14) of patients were in early stage of pregnancy while 63% (24) were in later stage of pregnancy and puerperium. Causes of AKI was post abortal sepsis in 23.6%, puerperal sepsis in 26.3%, haemorrhagic shock in 23.6%, eclampsia/pre-eclampsia/HELLP syndrome in 21%, IUD in 2nd trimester with sepsis in 2.6% and acute fatty liver of pregnancy in 2.6% of cases. Sepsis was the major cause accounting upto 52.6% of cases. Approximately 52.6% (20) of patients improved on treatment and dialysis, 21% did not improve (8), 13.15% (5) died and 13.15% (5) left against medical advice. Cause of death in 80% (4 out of 5) of patients was sepsis. Renal biopsy was performed on 62.5% of patients who did not improve (5 out of 8 patients). Renal transplant was done in 1 patients. Conclusion: Obstetric AKI is still a critical situation in developing countries and rare entity in developed countries. Maternal mortality has decreased but sepsis still accounts for majority of cases. Therefore early diagnosis and treatment is the need of the hour.
Authors and Affiliations
Sadia Parween, Archana Sinha, Harshvardhan . , Smita Kumari, Dipali Prasad, Neeru Goel
Keywords
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