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A Single-Centre Experience of Obstetric Acute Kidney Injury

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The Journal of Obstetrics and Gynecology of India Aims and scope Submit manuscript

Abstract

Background

Acute kidney injury (AKI) is a clinical syndrome characterized by a sudden decline in glomerular filtration rate leading to decreased excretion of nitrogenous waste products. It continues to be a common problem in developing countries.

Aims

The aim of this study was to understand AKI characteristics in pregnancy and identify the factors related to its unfavorable outcome.

Study Design

A prospective cross-sectional study.

Methods

This prospective study was conducted between January 2013 and May 2014. In total 570 women with AKI were referred to the Kidney Institute during this period, out of which 52 patients with obstetrics AKI were included in this study.

Results

Incidence of obstetric AKI was 9.12 %. Their age varied from 19 to 34 years, with an average of 26.2 years. About 42(80.8 %) patients had not received antenatal care. The main causes of AKI were obstetric hemorrhage (38.46 %) and puerperal sepsis (15.38 %). The outcome was favorable with complete renal function recovery in 55.76 % patients. Four (7.69 %) patients became dialysis dependent. Maternal mortality was 32.69 %.

Conclusion

Obstetric AKI is a critical situation in developing countries. Lack of antenatal care (80.8 %) is a major contributing factor for obstetric-related complications leading to renal failure. Obstetric hemorrhage (38.46 %) is the most common cause of obstetric AKI. Late referral in 18 (34.61 %), puerperal sepsis in six (33.33 %), obstetric hemorrhage in five (27.77 %) and combined sepsis and hemorrhage in five (27.77 %) are the common contributing factors leading to its unfavorable outcomes as maternal morbidity and mortality. Hence, a multidisciplinary approach is warranted to prevent such an avoidable complication.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, The Institute of Kidney Diseases and Research Centre and Institute of Transplantation Sciences, Ahmedabad, India

    V. Mishra Vineet, A. Goyal Preeti, S. Aggarwal Rohina, S. Choudhary, Tanvir Tanvir, D. Dharaiya Nisarg & A. Gaddagi Rashmi

Authors
  1. V. Mishra Vineet
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  2. A. Goyal Preeti
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  3. S. Aggarwal Rohina
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  4. S. Choudhary
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  5. Tanvir Tanvir
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  6. D. Dharaiya Nisarg
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  7. A. Gaddagi Rashmi
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Corresponding author

Correspondence to V. Mishra Vineet.

Ethics declarations

Conflict of interest

Vineet Mishra, Preeti Goyal, Rohina Aggarwal, Sumesh Choudhary, Nisarg Dharaiya and Rashmi Gaddagi declare that they have no conflicts of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Declaration of Helsinki 1975, as revised in 2008.

Informed consent

Informed consent was obtained from all patients for being included in the study.

Additional information

Mishra Vineet V, M.D, Ph.D., is the Professor and HOD in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Goyal Preeti A, M.D., is the Senior Resident in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Aggarwal Rohina S, M.D., is the Associate Professor in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Choudhary S, M.D, DNB, is the Assistant Professor in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Dr. Tanvir Tanvir, M.S., is the Senior Resident in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Dharaiya Nisarg D, M.D., is the Assistant Professor in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology; Gaddagi Rashmi A, M.S, is a fellow in Institute of Kidney Disease and Research Centre and Institute of Transplantation Sciences from Department of Obstetrics and Gynaecology.

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Mishra Vineet, V., Goyal Preeti, A., Aggarwal Rohina, S. et al. A Single-Centre Experience of Obstetric Acute Kidney Injury. J Obstet Gynecol India 66 (Suppl 1), 207–211 (2016). https://doi.org/10.1007/s13224-016-0839-5

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  • DOI: https://doi.org/10.1007/s13224-016-0839-5

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