22.Risk Factors and Prognosis of Acute Kidney Injury in Pre-Eclampsia
Muhammad Muzammil1, Asim Iqbal Qureshi2 and Humaira Imran2
ABSTRACT
Objective: To explore the risk factors and clinical outcomes in women with preeclampsia who developed AKI.
Study Design: A prospective observation study
Place and Duration of Study: This study was conducted at the gynecology department of Bakhtawar Amin Trust Teaching Hospital Multan from June 2020 to June 2021.
Materials and Methods: The study was conducted on pregnant women admitted to the hospital with pre-eclampsia. Women with maximum creatinine ≥90 μmol/L during admission were assessed for pre-pregnancy serial creatinine level. Kidney Disease Improving Global Outcomes criteria were adopted to evaluate the renal injury and its recovery. Predetermined risk factors, maternal and neonatal outcomes were contrasted between AKI stages.
Results: Among the total of 50 women with pre-eclampsia, 13 (26%) women qualified for the AKI KDIGO criteria. Of these, 7 (14%) had AKI stage 1, 4 (8%) had stage 2, and 2 (4%) had stage 3. Women with AKI (Stages 1-3) had a significantly higher incidence of stroke (risk ratio (RR), 15.5; 95% CI, 1.5- 157.7; p=0.012), eclampsia (RR, 1.6; 95% CI, 1.1-2.5; P=0.003) and were likely to die more (RR, 3.9; 95% CI, 1.2-12.3; P=0.002) than the woman who didn't develop AKI. Similarly, women with AKI were more prone to experience a stillbirth (RR, 1.9; 95% CI, 1.6-2.6; P<0.01) and neonatal death (RR, 2.3; 95% CI, 2.2-2.5; p=0.001). Hypertensive disorder in a previous pregnancy was the strongest predictor of the development and severity of AKI. It was found that the recovery rate reduced with an increase in the severity of the disease.
Conclusion: Conclusively, AKI was found to be a common complication in women with pre-eclampsia and resulted in considerable maternal and neonatal mortality. The failure to acquire absolute recovery of the affected population requires serious consideration of risk factors.
Key Words: AKI, pre-eclampsia, renal outcomes, pregnancy
Citation of article: Muzammil M, Qureshi AI, Imran H. Risk Factors and Prognosis of Acute Kidney Injury in Pre-Eclampsia. Med Forum 2021;32(11):90-94.