Prevalence, Clinical Features and Outcome of Post-Partum Acute Kidney Injury: A single Tertiary Center Study

Elsayed, Islam Ali; Ghonimi, Tarek A; Abd El-Hameed, Ayman Riyadh

doi:10.21608/zumj.2024.294428.3426

Prevalence, Clinical Features and Outcome of Post-Partum Acute Kidney Injury: A single Tertiary Center Study

Document Type : Original Article

Authors

¹ Lecturer of Internal medicine department, faculty of medicine, Zigzag University

² Professor of Internal medicine department, faculty of medicine, Zigzag University

³ Assistant Professor of internal medicine. Faculty of medicine. Zagazig university. Egypt

10.21608/zumj.2024.294428.3426

Abstract

Background: Pregnancy-related acute kidney injury (Pr-AKI) is a significant factor associated with increased maternal and fetal morbidity and mortality in developing countries. The aim of our study was to investigate the clinical data and associated outcomes in patients diagnosed with post-partum AKI (PP-AKI) at our center.

Methods: This prospective study at Zagazig University Hospital, Egypt, from October 1, 2023, to March 1, 2024, included patients with PP-AKI. These women were compared to a matched cohort of healthy pregnant women without pre-existing AKI. Multivariate analysis is used to identify risk factors.

Results: Out of 900 pregnant patients who delivered during the study period, 52 patients developed PP-AKI with prevalence of 5.7%. The majority were multiparous (59.6%), and most delivered by cesarean section (67.3%). The most common cause of AKI is preeclampsia (51.9%), followed by ante-partum hemorrhage (40.4%) and HEELP syndrome (36.5%). Stage 3 AKI (KDIGO classification) was the most prevalent occurring in 23% of cases. Maternal death occurred in 13.5% of cases, while fetal death was 17.3%. Follow- up showed that 42.3% had complete recovery, 30.7% CKD and 13.4% remained dialysis-dependent. Risk factors for AKI included high WBC, low Hb, low platelets, and high bilirubin levels, with p-values of 0.004, <0.0001, and 0.031, respectively. Additionally, nulliparous women had significantly lower odds of developing AKI (0.248, p = 0.017). However, the significance of these factors disappeared in multivariate analysis.

Conclusion: PP-AKI is a relatively common pregnancy complication with significant maternal and fetal mortality risks. Preeclampsia and ante-partum hemorrhage are major risk factors.

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