Acute kidney injury in pregnancy

Praveen, C. V.; Kaul, Anupama; Sharma, Raj Kumar

doi:10.1016/j.cqn.2016.04.003

Cited by 4 publications

(12 citation statements)

References 98 publications

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“…AKI was regarded as a rare but severe complication during pregnancy, which was associated with increased risk of poor outcomes [5]. Previous studies reported the incidence of pregnancy-related AKI has declined from 1/3000 to 1/20000 in developed countries, which was attributed to the improvement in antenatal care and decline of septic abortion [6]. However, the burden and risk profile of pregnancy-related AKI in developed countries might be different from that in developing world [5, 7, 8].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of acute kidney injury in hospitalized pregnant women in China

Liu

et al. 2019

BMC Nephrol

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Background Epidemiologic data of acute kidney injury (AKI) during pregnancy is lacking in China. This study aims to determine the effect of pregnancy on the risk of AKI among hospitalized women of childbearing age, and to describe the incidence, risk factors and outcomes of AKI in hospitalized pregnant women in China. Methods We previously conducted a nationwide, multi-centered cohort of hospitalized patients from 25 hospitals in China during 1/1/2013 to 31/12/2015. Women of childbearing age (14–50 year) who had at least two serum creatinine tests within any 7-day window were selected as analysis set. Patient-level data were obtained from the electronic hospitalization information system and laboratory databases. AKI events were identified according to the creatinine criteria of Kidney Disease Improving Global Outcomes. Results Among 110,873 women of childbearing age, pregnant women ( n = 10,920) had a 51% higher risk of AKI than non-pregnant women ( n = 99,953). Community acquired and hospital acquired AKI occurred in 3.6% ( n = 393) and 3.7% ( n = 402) of the pregnant women, respectively, giving rise to an overall AKI incidence of 7.3%. While, hospital coding would have identified less than 5% of AKI episodes. The top three risk factors of AKI during pregnancy, ranked in order of decreasing population attributable fractions were pregnancy-induced hypertension syndrome (21.1%), acute fatty liver (13.5%), and chronic kidney disease (6.2%). Conclusion AKI in pregnancy is associated with increased maternal mortality rate, longer length of stay and higher daily cost. AKI is a common and severe complication during pregnancy in China. Electronic supplementary material The online version of this article (10.1186/s12882-019-1255-8) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of acute kidney injury in hospitalized pregnant women in China

Liu

et al. 2019

BMC Nephrol

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“…En la Figura 4 se pueden observar los criterios diagnósticos de AKI aplicables para población general;sin embargo, diversos estudios han demostrado que la mayoría de los casos de Emb-LRA pertenecen a la categoría de estadio 1 de AKIN y que una categoría RIFLE más alta se asocia con peores resultados. El uso de la TFG como marcador de la función renal tiene ventajas sobre la creatinina sérica, ya que la primera puede disminuir incluso cuando la segunda es normal [25]. El cálculo de la TFGe no es exacto durante el embarazo: Smith et al [26] compararon la fórmula del estudio MDRD con el aclaramiento de inulina y creatinina mediante recolección de orina de 24 horas y Alper et al [27] compararon la ecuación MDRD con la ecuación de Cockcroft-Gault y el aclaramiento de creatinina por recolección de orina de 24 horas en mujeres con PE y ambos concluyeron que las fórmulas MDRD y Cockcroft-Gault eran inexactas para medir la TFG, ya que la fórmula MDRD subestima y la fórmula de Cockcroft-Gault sobreestima dicha tasa durante el embarazo.…”

Section: Diagnósticounclassified

“…El cálculo de la TFGe no es exacto durante el embarazo: Smith et al [26] compararon la fórmula del estudio MDRD con el aclaramiento de inulina y creatinina mediante recolección de orina de 24 horas y Alper et al [27] compararon la ecuación MDRD con la ecuación de Cockcroft-Gault y el aclaramiento de creatinina por recolección de orina de 24 horas en mujeres con PE y ambos concluyeron que las fórmulas MDRD y Cockcroft-Gault eran inexactas para medir la TFG, ya que la fórmula MDRD subestima y la fórmula de Cockcroft-Gault sobreestima dicha tasa durante el embarazo. De esta forma, el aclaramiento de creatinina mediante recolección de orina de 24 horas sigue siendo el método estándar de oro para estimar la TFG en el embarazo [25].…”

Section: Diagnósticounclassified

“…La reposición del volumen intravascular es crucial y tiene como objetivos principales restaurar y mantener la percusión renal para limitar en lo posible un daño mayor [23].Determinar la causa de la posible hipovolemia permitirá de nir el tipo de soluciones a utilizar; los cristaloides son los de elección para la mayoría de pacientes, no obstante es necesario reponer hemoderivados en las pacientes que lo requieran [25].…”

Section: Balance Hidroelectrolíticounclassified

“…Cabe resaltar que esta estrategia debe llevarse a cabo bajo estricta monitorización del balance hídrico para evitar el daño ocasionado por sobrecarga de volumen, tal como el desarrollo de edema pulmonar [12]. La adecuada corrección de volumen restablece la circulación uteroplacentaria adecuada y asegura el bienestar fetal [25].…”

Section: Balance Hidroelectrolíticounclassified

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Lesión renal aguda en la mujer embarazada

Robles¹,

Rico-Fontalvo

Daza-Arnedo

et al. 2020

Rev. Colomb. Nefrol.

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Aunque en la actualidad la lesión renal aguda en mujeres embarazadas es una complicación poco común, esta se correlaciona con peores desenlaces maternos y fetales. Sus causas son múltiples y varían según el trimestre de presentación. Los cambios fisiológicos renales durante el embarazo hacen que los criterios diagnósticos de lesión renal aguda en la población general no sean fácilmente extrapolables a las pacientes obstétricas, por lo que la sospecha temprana y eltratamiento oportuno son fundamentales para evitar la progresión del daño renal y sus complicaciones sistémicas asociadas, incluidas las metabólicas, urémicas e hidroelectrolíticas.

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HELLP Syndrome with Unusual Features in a Rare Setting

Amadi¹,

Amadi²

2021

EJCBS

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HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelet) syndrome is a rare disorder exclusively associated with pregnancy. It occurs mostly during the antepartum period in about 70% of cases but could also occur during the post-partum period in about 30% of reported cases especially during the first 48 hours following delivery. The syndrome is mostly reported among multiparous Caucasians in association with severe preeclampsia, hypertension, and proteinuria. It is rarely reported within Nigeria and the post-partum variant has never been documented among women of Nigerian origin in the literature to date. Herein, we report a very unusual case of HELLP syndrome in a very rare setting that developed eleven days post-partum without the usual features of hypertension and proteinuria in a 26-year-old G1P1. Upon presentation, she was promptly diagnosed and aggressively managed using standard protocols by a multidisciplinary medical team of specialists. She developed acute kidney injury (KDIGO stage 1) in the course of management of which she required conservative management. Remarkably, with supportive care, all the clinical and laboratory derangements, including hepatic and renal functions, normalized after seven days on admission. Her condition remained stable during weekly follow-up visits for four consecutive weeks. This case and its management protocols reinforce the need for a high index of clinical suspicion for this dreaded disorder and its prompt diagnosis/aggressive management even in very rare circumstances and settings.

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Acute kidney injury in pregnancy

Cited by 4 publications

References 98 publications

Epidemiology of acute kidney injury in hospitalized pregnant women in China

Epidemiology of acute kidney injury in hospitalized pregnant women in China

Lesión renal aguda en la mujer embarazada

HELLP Syndrome with Unusual Features in a Rare Setting

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