Najar M Saleem, Shah A Rashid, Wani I A, Reshi A Rashid, Banday K A, Bhat M Ashraf, Saldanha C L
Departments of Nephrology, and Gynaecology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, J & K, India.
Indian J Nephrol. 2008 Oct;18(4):159-61. doi: 10.4103/0971-4065.45291.
All patients admitted with pregnancy related acute renal failure (PRAKI) from June 2005 to May 2007 were studied with respect to etiology, clinical features, and outcome of PRAKI. Of 569 cases of acute kidney injury (AKI), 40 (7.02%) cases were related to gestational problems; the age of the patients ranged from 15 to 45 years. Septic abortion was the most common cause of PRAKI, accounting for 20 (50%) cases of which 15 (75%) cases occurred in the first and five (25%) in the second trimester. Other causes were antepartum hemorrhage: six cases (15%), toxemia of pregnancy: six cases (15%), acute gastroenteritis: three cases (7.5%), postpartum hemorrhage: two cases (5%), acute pyelonephritis: two cases (5%), and postpartum, acute kidney injury: one case (2.5%). Dialysis was needed in 60% of the cases and mortality was observed in 20% of the cases. PRAKI continues to be a major concern in our society, causing a high maternal mortality. Septic abortion which has virtually disappeared from developed countries, continues to be a major cause of PRAKI in our society. Hence, there is a need to halt the practice of illegal abortions and improve antenatal care.
对2005年6月至2007年5月期间所有因妊娠相关急性肾衰竭(PRAKI)入院的患者进行了病因、临床特征及PRAKI结局方面的研究。在569例急性肾损伤(AKI)病例中,40例(7.02%)与妊娠问题相关;患者年龄在15至45岁之间。感染性流产是PRAKI最常见的病因,占20例(50%),其中15例(75%)发生在孕早期,5例(25%)发生在孕中期。其他病因包括产前出血:6例(15%),妊娠中毒症:6例(15%),急性肠胃炎:3例(7.5%),产后出血:2例(5%),急性肾盂肾炎:2例(5%),以及产后急性肾损伤:1例(2.5%)。60%的病例需要透析,20%的病例观察到死亡。PRAKI在我们的社会中仍然是一个主要问题,导致孕产妇死亡率很高。在发达国家几乎已消失的感染性流产,在我们的社会中仍然是PRAKI的主要原因。因此,有必要停止非法堕胎行为并改善产前护理。