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急性肾损伤或慢性肾脏病孕妇的肾脏替代治疗应用:一项系统评价

Use of Renal Replacement Therapy in Pregnant Women with Acute Kidney Injury or Chronic Kidney Disease: A Systematic Review.

作者信息

Mulia Soto Ana Sarahi, Rodríguez Piña Miriam Deyanira, Santamaría Benhumea Acela Marlen, Mendieta Zerón Hugo

机构信息

Faculty of Medicine, Autonomous University of the State of Mexico.

Hospital Materno-Perinatal "Mónica Pretelini Sáenz".

出版信息

Acta Med Philipp. 2024 Oct 31;58(19):101-108. doi: 10.47895/amp.vi0.7369. eCollection 2024.

Abstract

OBJECTIVES

Acute Kidney Injury (AKI) during pregnancy is a complication that poses a serious risk of life for the mother and the fetus. In most cases, the treatment considered in the first instance is pregnancy interruption with subsequent conventional treatment of AKI. The aim of this review is to describe the risks and benefits of using renal replacement therapy [peritoneal dialysis (PD) and hemodialysis (HD)] in pregnant patients with AKI.

METHODS

A systematic review of pregnant women with AKI/CKD on RRT (pointing out the results of maternal and neonatal morbidity and mortality) in the last three decades was done between January and March 2021 using the databases Pubmed, LILACS, Cochrane, Tripdatabase, AJKD, and Elsevier. Articles in Spanish, English, and French languages were included. A summary of cases of pregnant women on RRT with women and fetus survival percentages was shown in a table.

RESULTS

Making a summary of all the included patients, it resulted in 1673 women, 1208 in HD and 170 in PD with 15 maternal deaths and survival percentages for the fetus of 74% in HD and 40% in PD.

CONCLUSION

The RRT in pregnant women with AKI/CKD offers a high survival rate for the women and fetus.

摘要

目的

妊娠期急性肾损伤(AKI)是一种并发症,对母亲和胎儿都构成严重的生命危险。在大多数情况下,首先考虑的治疗方法是终止妊娠,随后对AKI进行常规治疗。本综述的目的是描述在患有AKI的孕妇中使用肾脏替代疗法[腹膜透析(PD)和血液透析(HD)]的风险和益处。

方法

2021年1月至3月,使用PubMed、LILACS、Cochrane、Tripdatabase、AJKD和Elsevier数据库,对过去三十年中接受肾脏替代治疗(RRT)的AKI/CKD孕妇进行了系统综述(指出母婴发病率和死亡率的结果)。纳入西班牙语、英语和法语的文章。用表格展示了接受RRT的孕妇病例总结以及母婴存活率。

结果

对所有纳入患者进行总结,共有1673名女性,其中1208名接受血液透析,170名接受腹膜透析,有15例产妇死亡,血液透析组胎儿存活率为74%,腹膜透析组为40%。

结论

患有AKI/CKD的孕妇进行肾脏替代治疗可为母婴提供较高的存活率。

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