Abstract: SA-PO042

Pregnancy Related AKI: A Single Center Experience

Session Information

Category: Acute Kidney Injury

  • 003 AKI: Clinical and Translational

Author

  • L, Umesh, Institute of nephrourology, Bangalore, KARNATAKA, India
Background

The incidence of pregnancy-related acute renal failure (PRAKI) in the developed countries is 1–2.8%,
About 25% referrals to dialysis centres in the developing world comprise of pregnancy related acute kidney injury (PRAKI).It is associated with siginificant maternal and fetal mortality.

Methods

A prospective longitudinal observational study between February 2012 to april 2017.To evaluate the clinical, etiological and final outcome of AKI with special reference to pregnancy related acute kidney injury. AKI was diagnosed as per AKIN criterion with or without requiring hemodialysis.

Results

A total of 712 patients were studied. Among them 152 (21.34%) patients had PRAKI. The mean age among PRAKI was 21±5 years.The mean duration of hospital stay was 10.17± 6.7 days.
Etiological factors include puerperal sepsis in 77 (50.65%), pregnancy induced hypertension in 37(24.34%), 17(11.18%) patients had post partum hemorrhage, 9 (5.92%) ante partum hemorrhage, postpartum hemolytic uremic syndrome in 3 patients (1.97%) and miscellaneous causes was seen 9 (5.92%).
Biopsy was done on 34 patients who found to be oliguric or who needed dialysis support at the end of three weeks.
seventeen showed acute tubular necrosis. eleven of them had patchy cortical necrosis .three with features of acute interstitial nephritis Three patients had thrombotic microangiopathy.
Out of 152, 113 (74.34%) patients recovered from acute kidney injury, 10 patient remained on dialysis and seven patients had partial recovery from renal failure.
22 patients died with mortality rate of 14.47%.
Out of these 11 patients died within 48 hours of admission. Sepsis, multiorgan dysfunction, coagulation abnormalities and retained products of conception were factors associated with mortality.

Conclusion

PRAKI is a significant cause of AKI in developing countries.Puerperal sepsis is the most frequent etiological factor and accounted for a majority of maternal mortality