Khanal Namrata, Ahmed Ejaz, Akhtar Fazal
Renal Services, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand.
J Coll Physicians Surg Pak. 2010 Sep;20(9):599-603.
To determine the factors predicting renal outcome in patients developing acute renal failure in pregnancy.
Descriptive cohort study.
Study was conducted at Nephrology Unit of Sindh Institute of Urology and Transplantation, Karachi, from October 2006 to March 2007.
Patients with acute renal failure due to complications of pregnancy, with normal size of both the kidneys on ultrasound were enrolled, and followed for a period of 60 days or until recovery of renal function. Patient's age and parity, presence of antenatal care, type of complication of pregnancy, foetal outcome and duration of oliguria were compared between patients who remained dialysis dependent and those who recovered renal function. Chi-square/Fisher's exact test and student's t-test, were used for determining the association of categorical and continuous variables with dialysis dependency.
The mean age was 29+/-6 years. Most patients came from rural areas of interior Sindh. Sixty eight percent did not have antenatal checkups. Antepartum haemorrhage (p=0.002) and prolonged duration of oliguria (35+/-15.7 days, p= < 0.001) were associated with dialysis dependency, which was observed in 50% of the study group.
Ante-partum haemorrhage and prolonged oliguria were strong predictors of irreversible renal failure. This highlights the need for early recognition and referral, and the importance of trained birth attendants and antenatal care.
确定妊娠期间发生急性肾衰竭患者肾功能转归的预测因素。
描述性队列研究。
研究于2006年10月至2007年3月在卡拉奇信德泌尿学与移植研究所肾脏病科进行。
纳入因妊娠并发症导致急性肾衰竭且超声检查双肾大小正常的患者，随访60天或直至肾功能恢复。比较仍依赖透析的患者与肾功能恢复患者的年龄、产次、产前检查情况、妊娠并发症类型、胎儿结局及少尿持续时间。采用卡方检验/费舍尔精确检验和学生t检验确定分类变量和连续变量与透析依赖的相关性。
平均年龄为29±6岁。大多数患者来自信德省内陆农村地区。68%的患者未进行产前检查。产前出血（p = 0.002）和少尿持续时间延长（35±15.7天，p < 0.001）与透析依赖相关，研究组中50%的患者出现透析依赖。
产前出血和少尿持续时间延长是不可逆肾衰竭的强预测因素。这凸显了早期识别和转诊的必要性，以及训练有素的助产士和产前护理的重要性。
