Characteristics, risk factors and outcomes of Pregnancy related Acute
Kidney Injury: A Middle-east tertiary center experience
Abstract
Abstract Introduction Acute kidney injury in pregnancy, while is now a
rare entity in the developed countries, it is still a common issue in
developing countries representing a major cause of maternal and fetal
morbidity and mortality. Scarce data are published regarding PRAKI in
Middle-east and African countries. Here, we present our experience in
Mansoura University Hospital; an Egyptian tertiary care hospital.
Methods This is a prospective observational study that included all
patients with pregnancy related Acute Kidney Injury admitted to Mansoura
Nephrology and Dialysis Unit over two years. All patients were
prospectively followed for three months. All patients were evaluated
regarding their maternal, fetal and renal outcomes. Results Preeclampsia
and peri-partum hemorrhage constituted the most common causes of PRAKI.
Maternal mortality occurred in 22.5% of patients. Regarding patients’
renal outcomes, the major portion of patients (62.5%) fully recovered
while the remaining (37.5%) didn’t recover and became dialysis
dependent. Fetal unfavorable events occurred in 31 pregnancies (77.5%),
where 10 babies (25%) were delivered prematurely and 21 fetuses
(52.5%) died intra-uterine. Fetal mortality was 45%, of those 70%
occurred in patients with AKI on top of preeclampsia. Conclusion
Pregnancy related acute kidney injury represents a continuous burden in
low-income countries. A global strategy should be implemented to reduce
its incidence and its related adverse consequences on both mother and
fetus. The paucity of data in this field reflects the importance of
implementing further research studies to deeply understand the
precipitating and key pathophysiologic mechanisms involved in this
disease.