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Journal of Anesthesia

, Volume 32, Issue 5, pp 787–787 | Cite as

Acute kidney injury in parturients with severe preeclampsia

  • Sun-Kyung Park
  • Min Hur
  • Won Ho Kim
Letter to the Editor
  • 403 Downloads

Keywords

Acute kidney injury Cesarean section Preeclampsia 

To the Editor:

We read with interest the study by Mazda et al. [1] regarding postoperative acute kidney injury (AKI) in parturients with severe preeclamsia. We would like to discuss the clinical implication of the study. First, the effect of hydroxyl ethyl starch (HES) administration was not evaluated fully. Clinical outcomes other than AKI were not compared with a control group. Although not clearly shown, the number of patients with proteinuria or elevated serum creatinine seems to be very small. The incidence of AKI and the impact of HES on AKI may be different in the more selected patients with severe preeclampsia with renal dysfunction [2]. Second, the serum creatinine measurement may not be a reliable estimation of glomerular filtration rate (GFR) in these parturients [3]. Delivery itself and different oral intakes after surgery may influence serum creatinine and following creatinine after delivery may not be accurate. GFR increases up to 50% during pregnancy and continue at levels 20% above normal at postpartum week [4]. Diagnosis of AKI in these patients using other measurement of GFR or more sensitive biomarkers may be required.

Notes

Compliance with ethical standards

Conflict of interest

No competing interest declared.

References

  1. 1.
    Mazda Y, Tanaka M, Terui K, Nagashima S, Inoue R. Postoperative renal function in parturients with severe preeclampsia who underwent cesarean delivery: a retrospective observational study. J Anesth. 2018;32:447–51.CrossRefGoogle Scholar
  2. 2.
    Awowole IO, Omitinde OS, Arogundade FA, Bola-Oyebamiji SB, Adeniyi OA. Pregnancy-related acute kidney injury requiring dialysis as an indicator of severe adverse maternal morbidity at a tertiary center in Southwest Nigeria. Eur J Obstet Gynecol Reprod Biol. 2018;225:205–9.CrossRefGoogle Scholar
  3. 3.
    Heimburger O, Stenvinkel P, Barany P. The enigma of decreased creatinine generation in acute kidney injury. Nephrol Dial Transpl. 2012;27:3973–4.CrossRefGoogle Scholar
  4. 4.
    Cheung KL, Lafayette RA. Renal physiology of pregnancy. Adv Chronic Kidney Dis. 2013;20:209–14.CrossRefGoogle Scholar

Copyright information

© Japanese Society of Anesthesiologists 2018

Authors and Affiliations

  1. 1.Department of Anesthesiology and Pain MedicineSeoul National University HospitalSeoulRepublic of Korea

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