Obstetric Acute Kidney Injury; A Three Year Experience at a Medical College Hospital in North Karnataka,India
Introduction: Acute kidney injury is a rare and sometimes fatal complication of pregnancy, the incidence of which has been declining worldwide, though still high in developing countries. There are recent observations of increasing incidence in some developed countries attributed to hypertensive...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2015-03-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/5634/12897_CE(RA1)_F(T)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
| Summary: | Introduction: Acute kidney injury is a rare and sometimes fatal
complication of pregnancy, the incidence of which has been
declining worldwide, though still high in developing countries.
There are recent observations of increasing incidence in some
developed countries attributed to hypertensive disorders of
pregnancy.
Materials and Methods: In this study, we have analysed the
records of all patients referred to the dialysis unit of a medical
college hospital in Karnataka for acute kidney injury related
to pregnancy. AKIN (Acute Kidney Injury Network) criteria for
the diagnosis of acute kidney injury were adapted. Age, parity,
gestational age, causative factors for acute kidney injury, mode
of delivery, access to antenatal care, operative procedures, blood
component transfusions, number of haemodialysis, time for
initiation of haemodialysis, duration of hospital stay and mortality
were analysed by finding mean, standard deviation and standard
error.
Results: Fifteen patients out of 21563 who delivered in our
hospital developed acute kidney injury. These (n=15) were out
of 149 patients of acute kidney injury of various aetiologies who
underwent haemodialysis between 2012 and 2014. Of these two
were unregistered for antenatal care. Ten were multiparous, Eleven
were from rural background, one had home delivery, six had
vaginal delivery, seven had caesarean section and two had second
trimester abortion. Placental abruption with intrauterine death
was the commonest Cause in 9 out of 15 cases. All had severe
anaemia. Patients received a mean of 3.9 (SD+/- 2.4) sessions of
haemodialysis. Eleven patients recovered completely, two died and
two left against medical advice.
Conclusion: Obstetric acute kidney injury is associated with
poor access to antenatal care, multiparity and rural background.
Placental abruption is the commonest cause of obstetric acute
kidney injury. Blood component transfusions, avoidance of
nephrotoxic drugs and early initiation of haemodialysis are
associated with better outcome. |
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| ISSN: | 2249-782X 0973-709X |