Departments of Nephrology and Rheumatology, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai, China.
Int Urol Nephrol. 2023 Sep;55(9):2249-2255. doi: 10.1007/s11255-023-03484-6. Epub 2023 Feb 28.
Acute kidney injury (AKI) seriously affects the health of both pregnant women and fetuses. This study aimed to investigate the clinical characteristics and prognosis of pregnancy-related AKI (PR-AKI).
This case series study enrolled pregnant women with PR-AKI admitted to the surgical intensive care unit of Xinhua Hospital affiliated to Shanghai Jiaotong University School of Medicine between January 2010 and December 2020.
Thirty-one PR-AKI patients were enrolled with a mean age of 29.16 ± 4.97 years. Seventeen pregnant women (54.84%) had complete recovery of renal function, 5 (16.13%) had partial recovery of renal function, 2 (6.45%) patients had no renal function improvement, and 7 (22.58%) died. Among the 31 patients with 35 fetuses, 25 (80.6%) pregnant women had poor fetal outcomes, including 5 cases of stillbirths, 5 neonatal asphyxia, 18 premature births, 10 low birth weight, and 8 deficient birth weight infants. Compared to cases with good fetal outcomes, cases with poor fetal outcomes had significantly shorter gestational weeks (39.26 ± 1.53 vs. 31.62 ± 5.50, P = 0.002), lower platelet count (217.13 ± 122.87 vs. 90.24 ± 84.88, P = 0.005), lower hemoglobin (94.19 ± 13.21 vs. 74.48 ± 20.78, P = 0.036), higher blood urea nitrogen (11.87 ± 4.28 vs. 19.47 ± 10.98, P = 0.013), and higher uric acid (262.41 ± 167.00 vs. 586.87 ± 144.52, P < 0.001).
The maternal renal function of women with PR-AKI might improve after treatment, but occurrence rates of adverse fetal outcomes were still high.
急性肾损伤（AKI）严重影响孕妇和胎儿的健康。本研究旨在探讨与妊娠相关的 AKI（PR-AKI）的临床特征和预后。
本病例系列研究纳入了 2010 年 1 月至 2020 年 12 月期间上海交通大学医学院附属新华医院外科重症监护病房收治的 PR-AKI 孕妇。
31 例 PR-AKI 患者纳入研究，平均年龄为 29.16±4.97 岁。17 例孕妇（54.84%）肾功能完全恢复，5 例（16.13%）部分恢复，2 例（6.45%）无肾功能改善，7 例（22.58%）死亡。31 例患者中，有 35 例胎儿，25 例（80.6%）孕妇发生不良胎儿结局，包括 5 例死胎、5 例新生儿窒息、18 例早产、10 例低出生体重儿和 8 例低出生体重儿。与胎儿结局良好的病例相比，胎儿结局不良的病例的妊娠周数明显缩短（39.26±1.53 与 31.62±5.50，P=0.002），血小板计数较低（217.13±122.87 与 90.24±84.88，P=0.005），血红蛋白较低（94.19±13.21 与 74.48±20.78，P=0.036），血尿素氮较高（11.87±4.28 与 19.47±10.98，P=0.013），尿酸较高（262.41±167.00 与 586.87±144.52，P<0.001）。
PR-AKI 妇女的肾功能在治疗后可能会改善，但不良胎儿结局的发生率仍很高。
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