Obstetric Acute Kidney Injury; A Three Year Experience at a Medical College Hospital in North Karnataka,India

Dambal, Archana; Lakshmi, K. S.; Gorikhan, G; Padaki, S

doi:10.7860/jcdr/2015/12897.5634

Cited by 5 publications

(5 citation statements)

References 6 publications

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“…Dambal A et al, reported 73.3% were from rural and Goplani KR et al, also reported 70% were from rural. 7 Patients in rural areas would have delayed early access during the emergency even though toxaemia was more common in urban residency patients.…”

Section: Discussionmentioning

confidence: 99%

“…6 The incidence and the mortality associated with PRAKI have decreased in developed countries from 40% to 20% in 1960 to <10% in recent series mostly due to meticulous antenatal management. 7 Female gender is as such increases the susceptibilities for non-specific AKI. 3 PRAKI may be due to a decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions.…”

Section: Aki Is Defined As Any Of the Followingmentioning

confidence: 99%

“…3 PRAKI may be due to a decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions. 7 These include hyperemesis gravidarum, postpartum haemorrhage, hypertensive disorders, thrombotic microangiopathies, acute fatty liver of pregnancy, septic abortion, sepsis, acute fatty liver of pregnancy and complicated urinary tract infections. 8 Recently reported incidence of postpartum AKI (PP-AKI) is 10.55% sepsis and haemorrhage being the commonest aetiologies.…”

Section: Aki Is Defined As Any Of the Followingmentioning

confidence: 99%

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Acute kidney injury in obstetrics: a five-year study in a tertiary centre

Papegowda

Devi

Singh

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: Pregnancy Related Acute Kidney Injury (PRAKI) is a major cause of maternal and foetal morbidity and mortality in developing countries. The incidence has declined due to improvements in reproductive health but it is still associated with significant perinatal mortality and maternal morbidity. It may be due to decrease in renal perfusion or ischemic tubular necrosis from a variety of conditions encountered during pregnancy. Our study aims at determining the predisposing factors and causes of AKI during pregnancy and its impact on maternal and foetal outcome.Methods: A retrospective cohort study over a period of 5 years was conducted on pregnant women with AKI as per inclusion and exclusion criteria. The detailed history, events, mode of delivery, cause leading to AKI, management, hospital stay, maternal and foetal outcome were studied in detail and evaluated. These patients were classified according to RIFLE criteria and were followed up for hospital stay and residual morbidities.Results: The incidence of PRAKI in the study was 0.07% (36 out of 50,735 deliveries) and among obstetric ICU patients, it was 6.8%. Most of the majority of the cases were unbooked (66.7%) and multipara (61.1%). Maternal morbidity was seen in 66.7% and mortality was 27.8%. Poor foetal outcome was seen in 44.4%.Conclusions: Haemorrhage is the most common cause of PRAKI, followed by toxaemia of pregnancy and sepsis. Early detection and meticulous management of haemorrhage, hypertension and sepsis reduce the incidence of PRAKI and associated maternal mortality.

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Section: Discussionmentioning

confidence: 99%

Section: Aki Is Defined As Any Of the Followingmentioning

confidence: 99%

Section: Aki Is Defined As Any Of the Followingmentioning

confidence: 99%

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Acute kidney injury in obstetrics: a five-year study in a tertiary centre

Papegowda

Devi

Singh

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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“…A couple of reports from India found AKI in 0.06%-2% of delivery cases, with placental abruption, pre-eclampsia, puerperal sepsis being the leading causes of pregnancy-related AKI. 30,31 This is in contrast with the patterns of AKI in high-income countries which tend to be more senile, comorbid with chronic diseases, complicated with postsurgical conditions, and often develop as hospital-acquired AKI. 32,33 The futility of treatment in this specific population contributes to withhold RRT treatment.…”

Section: Environmental and Exposure Factorsmentioning

confidence: 92%

“…Obstetric complication deserves special consideration as a cause of AKI in Asia. A couple of reports from India found AKI in 0.06%–2% of delivery cases, with placental abruption, pre‐eclampsia, puerperal sepsis being the leading causes of pregnancy‐related AKI 30,31 …”

Section: Barriers Of Crrt In Developing Worldmentioning

confidence: 99%

CRRT in developing world

Srisawat

Chakravarthi²

2021

Seminars in Dialysis

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Acute renal replacement therapy (RRT) is a mainstay therapy, 1 that is applied in 8%-13.5% of critically ill patients with severe acute kidney injury (AKI). [2][3][4][5] Noticeably, a previous survey showed that intermittent hemodialysis (IHD), peritoneal dialysis (PD), and continuous RRT (CRRT) were widely applied for the modalities of acute RRT. 6 Over the past decade, CRRT has become the preferred modality among nephrologists and intensivist community. 7 Data from AKI-EPI study clearly found that CRRT is the predominant form of initial acute therapy in over 75% of critically ill patients 3 and had become widely accepted worldwide. However, little is known about CRRT adoption and practice in the developing world. Many national and international surveys of the current practice of RRT management were previously conducted in developed countries such as Australia, Europe, 7 New Zealand, 8 UK, 9 and Japan. 10 In this review, we focus on the current situation of CRRT practice in the developing world, barriers to implement the CRRT program, and strategies to improve the adoption of CRRT in the developing world. | CURRENT S ITUATI ON OF CRRT IN THE DE VELOPING WORLDThe epidemiology of AKI and acute RRT in resource-limited settings have not been well-established due to their limited healthcare resources, lack of adequate patient registry, and low awareness of AKI.Recently, there were published meta-analyses of global AKI burden reporting that KDIGO-defined pooled AKI incidences in hospitalized

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Acute Kidney Injury Recognition in Low- and Middle-Income Countries

Cerdá

Mohan

Garcia-Garcia

et al. 2017

Kidney International Reports

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Acute kidney injury (AKI) is increasingly common around the world. Because of the low availability of effective therapies and resource limitations, early preventive and therapeutic measures are essential to decrease morbidity, mortality, and cost. Timely recognition and diagnosis of AKI requires a heightened degree of suspicion in the appropriate clinical and environmental context. In low- and middle-income countries (LMICs), early detection is impaired by limited resources and low awareness. In this article, we report the consensus recommendations of the 18th Acute Dialysis Quality Initiative meeting in Hyderabad, India, on how to improve recognition of AKI. We expect these recommendations will lead to an earlier and more accurate diagnosis of AKI, and improved research to promote a better understanding of the epidemiology, etiology, and histopathology of AKI in LMICs.

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Obstetric Acute Kidney Injury; A Three Year Experience at a Medical College Hospital in North Karnataka,India

Abstract: anti-biotic policy and pain control needs to be studied for reducing the incidence of obstetric acute kidney injury.

Cited by 5 publications

References 6 publications

Acute kidney injury in obstetrics: a five-year study in a tertiary centre

Acute kidney injury in obstetrics: a five-year study in a tertiary centre

CRRT in developing world

Acute Kidney Injury Recognition in Low- and Middle-Income Countries

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