Frequency of pregnancy-related complications causing acute kidney injury in pregnant patients at a tertiary care hospital

• Published in: Saudi journal of kidney diseases and transplantation 2019, Vol.30 (1), p.194-201
• Main Authors: Ahmad, Asim, Imtiaz, Salman, Dhrolia, Murtada F., Harun, Fawziyah, Qurayshi, Ruqayah
• Format: Article
• Language: English
• Subjects: Abortion; Acute kidney failure; Acute Kidney Injury - epidemiology; Acute Kidney Injury - etiology; Adult; Age; Cross-Sectional Studies; Female; Health aspects; Health care access; Health facilities; Hemorrhage; Humans; Kidneys; Maternal mortality; Morbidity; Mortality; Nephrology; Obstetrics; Pakistan - epidemiology; Patients; Preeclampsia; Pregnancy; Pregnancy complications; Pregnancy Complications - epidemiology; Pregnant women; Prenatal care; Risk factors; Sepsis; Womens health; Young Adult; الحمل; الفشل الكلوي
• ISSN: 1319-2442; 2320-3838
• DOI: 10.4103/1319-2442.252910

Acute kidney injury (AKI) in pregnancy is associated with significant maternal morbidity and mortality. Several studies from worldwide have shown different frequencies of the causes of pregnancy-related AKI (PRAKI). The present study aimed to provide local data on frequency of causes of PRAKI. A total of 111 pregnant women using nonprobability consecutive sampling technique, with the age group of 18–45 years, admitted with the diagnosis of PRAKI were included in the study. The information regarding age, duration of pregnancies, serum creatinine levels, and outcome variables (complications) were collected from each patient. Effect modifiers were controlled by stratification. The mean age was 29.90 ± 5.40 years. Out of 111 cases, 10 (9%) developed AKI in the 1 st trimester, 12 (10.8%) in the 2 nd trimester, 13 (11.7%) cases in the 3 rd trimester, and rest of the 76 (68.4%) cases were of the postpartum period. The etiology of PRAKI was multifactorial in several patients. The frequencies of complication leading to AKI were observed individually. The results showed that 21 (18.9%) had antepartum hemorrhage, 41 (36.9%) postpartum hemorrhage, 33 (29.7%) puerperal sepsis, 11 (9.9%) preeclampsia, 13 (11.7%) eclampsia, 11 (9.9%) hemolysis, elevated liver enzymes, and low-platelet count syndrome, 7 (6.3%) hemolytic uremic syndrome, and 5 (4.5%) had hyperemesis gravidarum. The results of the present study showed no statistically significant association of age with the individual complications with P >0.05. AKI during pregnancy was mostly due to prerenal causes. The most common cause was postpartum hemorrhage followed by puerperal sepsis and antepartum hemorrhage.