38.Etiology and Outcomes of Post-Partum Acute Kidney Injury: A Hospital Based Cross Sectional Study
Khawar Sultan1, Zainab Maqsood1, Muhammad Sajid Rafique Abbasi3, Kanza Kanwal1 Meshaal Azhar4 and Faryal Azhar4
ABSTRACT
Objective: This study is designed to determine various risk factors, causes and outcome of Post-Partum Acute Kidney Injury in a tertiary care hospital of Pakistan.
Study Design: Cross sectional / descriptive study
Place and Duration of Study: This study was conducted at the Nephrology Department and MCH Center of PIMS Islamabad from January 1, 2018 to December 31, 2019.
Materials and Methods: 60 patients were included in this study who were previously healthy and developed acute kidney injury in Post-Partum period. A rise of > 0.3mg/dl in serum creatinine or urine output < 0.5ml/kg/h for 6 hours is defined as Acute Kidney Injury. Detail history was taken though a predesigned form to explore risk factors and causes. Cause of AKI was established though history, through examination and laboratory investigations as required. Course of disease and management was also reviewed. Patients were followed up for 3 months to see disease outcomes. Return to normal renal function was labelled as complete recovery while impaired renal function beyond 3 months during follow up was labelled as CKD.
Results: In our study Puerperal sepsis was the leading cause of post-partum AKI in 35 (58.3%) patients. Second leading cause of PPAKI was pre-eclampsia /eclampsia in 8 (13.4%) patients followed by DIC in 7 (11%) patients and Ante-partum/Post-Partum hemorrhage in 6 (10%) patients. Patients with HELLP were 3 (5%) and HUS 1 (1.6%). Out of 60 patients 12 (20%) patients responded to conservative management while 48 (80%) patients required hemodialysis. During follow up 41 (68.3%) patients achieved complete recovery of renal functions, 15 (25%) patients had partial recovery of renal function and labelled as chronic kidney disease (CKD) while 3 (5%) became dialysis dependent and labelled as ESRD. 1 (1.6%) patient expired during hospital stay due to sepsis.
Conclusion: In our study puerperal Sepsis is the most common cause of Post-Partum Acute Kidney Injury.
Key Words: Acute kidney injury (AKI), Pregnancy, puerperal sepsis
Citation of article: Sultan K, Maqsood Z, Abbasi MSR, Kanwal K, Azhar M, Azhar F. Etiology and Outcomes of Post-Partum Acute Kidney Injury: A Hospital Based Cross Sectional Study. Med Forum 2021;32(7):165-168.