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Acute kidney injury during pregnancy and puerperium: an Egyptian hospital-based study

  • Original Article
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Abstract

Introduction

While acute kidney injury (AKI) in pregnancy is currently a rare entity in developed countries, it is still a common occurrence in developing countries, representing a major cause of maternal and fetal morbidity and mortality. Scarce data are published regarding pregnancy-related acute kidney injury (PRAKI) in Middle Eastern and African countries. The aim of this work is to report on the frequency, the underlying causes, and the outcomes of patients with PRAKI in an Egyptian tertiary care hospital.

Methods

This is a prospective observational study that included 40 patients representing all women who presented to the Mansoura Nephrology and Dialysis Unit with PRAKI over two years. All patients were followed up for three months after hospital discharge to assess renal outcome, and till the end of pregnancy to assess the maternal and fetal outcomes.

Results

PRAKI was reported  in about 1% of women who presented to the obstetrics service, and accounted for 14% of all AKI patients who presented to the renal service in our hospital. Preeclampsia (PE) and obstetric hemorrhage were the commonest causes of PRAKI. Maternal mortality occurred in 22.5% of PRAKI patients. The majority of survivors (62.5%) fully recovered, while the remaining (37.5%) individuals became dialysis dependent. Unfavorable fetal events occurred in 24 pregnancies (60%).

Conclusion

In our hospital in Mansoura, Egypt, PRAKI represents a relevant burden with potential ominous outcomes obstetric hemorrhage and preeclampsia were the major causes. Further research is needed to understand the causes and improve the outcomes of pregnancy-related AKI.

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Availability of data and materials

All data generated or analyzed during this study are included in this published article [and its supplementary information files] and readily available for share.

Abbreviations

PRAKI:

Pregnancy-related acute kidney injury

AKI:

Acute kidney injury

UOP:

Urine output

PE:

Preeclampsia

DIC:

Disseminated intravascular coagulation

HELLP/HUS:

Hemolysis-elevated liver enzymes-low platelet count/hemolytic uremic syndrome

IUFD:

Intrauterine fetal death

CS:

Cesarean section

UTI:

Urinary tract infection

BP:

Blood pressure

HTN:

Hypertension

WBC:

White blood cell count

ICU:

Intensive care unit

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Funding

No funding has been made available for this work.

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Authors and Affiliations

  1. Faculty of Medicine, Mansoura University, Mansoura, Dakahliya, Egypt

    Tamer Z. Gaber, Rasha S. Shemies, Azza A. Baiomy, Doaa A. Aladle, Alaa Mosbah, El Said Abdel-hady, Nagy Sayed-Ahmed & Mohammed Sobh

Authors
  1. Tamer Z. Gaber
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  2. Rasha S. Shemies
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  3. Azza A. Baiomy
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  4. Doaa A. Aladle
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  5. Alaa Mosbah
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  6. El Said Abdel-hady
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  7. Nagy Sayed-Ahmed
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  8. Mohammed Sobh
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Contributions

Conceptualization and Methodology: RSS, TZG, MS; formal analysis and investigation: AB, DAA; writing—original draft preparation: RSS, TZG; writing—review and editing: NSA; supervision: AM, ESA.

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Correspondence to Tamer Z. Gaber.

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On behalf of all authors, the corresponding author states that there is no conflict of interest.

Ethics approval and consent to participate

The study adhered to the Declaration of Helsinki and approved by the ethics committee at our university.

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Gaber, T.Z., Shemies, R.S., Baiomy, A.A. et al. Acute kidney injury during pregnancy and puerperium: an Egyptian hospital-based study. J Nephrol 34, 1611–1619 (2021). https://doi.org/10.1007/s40620-021-01133-8

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  • DOI: https://doi.org/10.1007/s40620-021-01133-8

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