Haroon Fauzia, Dhrolia Murtaza F, Qureshi Ruquayya, Imtiaz Salman, Ahmed Aasim
Department of Nephrology, Jinnah Postgraduate Medical Center, Karachi, Pakistan.
Department of Nephrology, The Kidney Centre Postgraduate Training Institute, Karachi, Pakistan.
Saudi J Kidney Dis Transpl. 2019 Jan-Feb;30(1):194-201.
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 trimester, 12 (10.8%) in the 2 trimester, 13 (11.7%) cases in the 3 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.
妊娠期急性肾损伤(AKI)与孕产妇的高发病率和死亡率相关。来自世界各地的多项研究表明,与妊娠相关的急性肾损伤(PRAKI)的病因频率各不相同。本研究旨在提供PRAKI病因频率的本地数据。本研究纳入了111名采用非概率连续抽样技术、年龄在18 - 45岁之间、诊断为PRAKI的孕妇。收集了每位患者的年龄、妊娠时长、血清肌酐水平以及结局变量(并发症)等信息。通过分层控制效应修饰因素。平均年龄为29.90±5.40岁。在111例病例中,10例(9%)在妊娠早期发生AKI,12例(10.8%)在妊娠中期,13例(11.7%)在妊娠晚期,其余76例(68.4%)发生在产后。在一些患者中,PRAKI的病因是多因素的。分别观察了导致AKI的并发症发生频率。结果显示,21例(18.9%)发生产前出血,41例(36.9%)发生产后出血,33例(29.7%)发生产褥期败血症,11例(9.9%)发生先兆子痫,13例(11.7%)发生子痫,11例(9.9%)发生溶血、肝酶升高和血小板减少综合征,7例(6.3%)发生溶血性尿毒症综合征,5例(4.5%)发生妊娠剧吐。本研究结果显示,年龄与各并发症之间无统计学显著关联,P>0.05。妊娠期AKI主要是由肾前性原因引起的。最常见的原因是产后出血,其次是产褥期败血症和产前出血。