Muhammad Noor, Liaqat Nazia
Noor Muhammad, MBBS, MCPS, FCPS Assistant Professor, Department of Nephrology. Medical Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Nazia Liaqat, MBBS, FCPS Assistant Professor, Department of Gynecology. Medical Teaching Institute, Lady Reading Hospital, Peshawar, Pakistan.
Pak J Med Sci. 2024 Jan-Feb;40(1Part-I):64-67. doi: 10.12669/pjms.40.1.7444.
To determine frequencies of causes and renal outcomes of pregnancy related acute kidney injury.
This descriptive case series study was conducted in Nephrology unit of a tertiary care hospital of Peshawar, from 1 August 2021 to 31 July 2022.A total of 100 patients with acute kidney injury secondary to obstetric conditions were enrolled via non-probability consecutive sampling technique. While patients with pre-existing renal disease, those with renal stones, or having bilateral small kidneys on ultrasound were excluded from the study. Patients were followed till 12 weeks postpartum period. Underlying obstetrical causes and outcome at 12 weeks postnatal period were determined.
The mean age of sample of 100 cases was 29.29 ± 6.45. Mean serum creatinine at presentation was 6.5± 3.13. Majority of patient, 89% were multigravidas. Seventy eight percent patients required hemodialysis. Primary postpartum hemorrhage remained the commonest underlying cause of pregnancy related acute kidney injury in this study. The frequency of persistent renal failure in Pr-AKI (pregnancy related acute kidney injury) in this study was 14%. In about 66% of cases complete recovery occurred. All the underlying obstetrical causes, when adjusted for age, gravidity, place and mode of delivery, had no association with persistent renal failure.
Primary postpartum hemorrhage is the predominant cause of pregnancy related acute kidney injury. By the end of 12 weeks postpartum, two third patients recover completely from pregnancy related acute renal injury.
确定妊娠相关急性肾损伤的病因频率和肾脏转归。
本描述性病例系列研究于2021年8月1日至2022年7月31日在白沙瓦一家三级护理医院的肾病科进行。通过非概率连续抽样技术纳入了100例继发于产科情况的急性肾损伤患者。而患有既往肾病、肾结石或超声显示双侧小肾脏的患者被排除在研究之外。对患者进行随访直至产后12周。确定潜在的产科病因和产后12周时的转归。
100例样本的平均年龄为29.29±6.45。就诊时的平均血清肌酐为6.5±3.13。大多数患者（89%）为经产妇。78%的患者需要血液透析。在本研究中，原发性产后出血仍然是妊娠相关急性肾损伤最常见的潜在病因。本研究中妊娠相关急性肾损伤（Pr-AKI）持续肾衰竭的发生率为14%。约66%的病例完全恢复。所有潜在的产科病因，在调整年龄、孕次、分娩地点和方式后，与持续肾衰竭均无关联。
原发性产后出血是妊娠相关急性肾损伤的主要原因。产后12周时，三分之二的患者从妊娠相关急性肾损伤中完全恢复。
