Outcome assessment of pregnancy-related acute kidney injury in Morocco: A national prospective study

Abstract

Acute kidney injury (AKI) is a rare but life-threatening complication of pregnancy. The aim of this paper is to study the characteristics of acute AKI in pregnancy and to emphasize on its management modalities in Moroccan hospitals. This is a national prospective study performed over six months from July 1 to December 31 2010 on AKI developing in pregnant patients, both preand post-partum period. Patients with pre-existing kidney disease were excluded from the study. Outcome was considered unfavorable when complete recovery of renal function was not achieved and/or maternal death occurred. Forty-four patients were included in this study. They were 29.6 ± 6 years old and mostly illiterate (70.6%). Most AKI occurred in the post-partum period, with 66% of the cases occurring in those who did not receive antenatal care. The main etiologies were pre-eclampsia (28 cases), hemorrhagic shock (six cases) and septic events (five cases). We noted three cases of acute fatty liver, one case of obstructive kidney injury and one case of lupus nephritis. Hemodialysis was necessary in 17 (38.6%) cases. The outcome was favorable in 29 patients. The maternal mortality rate was 11.4%. Two poor prognostic factors were identified: Age over 38 years and sepsis. AKI is a severe complication of pregnancy in developing countries. Its prevention necessitates the improvement of the sanitary infrastructure and the establishment of the obligatory antenatal care.

Pregnancy outcomes in patients with acute kidney injury during pregnancy: a systematic review and meta-analysis

“…The maternal mortality was higher than that in normal gravida without acute kidney injury, so well as the rate of fetal loss. The maternal mortality of 13.3% in women with pregnancy related acute kidney injury in our study was similar to some of the studies reported by Kabbali et al (11.4%) [26], Godara et al (15.7%) [5], Hassan et al (16.2%) [27] from developing countries. The fetal mortality was observed in 29.8% of the pregnancies, which was higher than controls (6.0%).…”

Acute Kidney Failure during Preeclampsia at Parakou University Hospital in Benin in 2019: Diagnostic and Therapeutic Aspects

“…Similar rates had been reported by other authors including Tondi ZMM, et al (40.5%) and Ahoui S, et al (44.71%) [19,7]. For Kabbali N, et al more than half of the patients were in oliguria (57%) [29]. In the series by Hachim K, et al, 71% of patients were in oliguria [26].…”

“…The average serum creatinine in our study was 164 ± 10.27 mg/L. It is higher than those of Kabbali N, et al (48.41 ± 37.32 mg/L) and Hachim K (95.85 ± 57.36 mg/L) but lower than that reported by Tondi ZMM, et al (352 ± 100 mg/L) [29,26,19]. Creatinine, substance nitrogen comes from the breakdown of creatine, especially present in the muscles.…”

“…O p e n H U B f o r S c i e n t i f i c R e s e a r c h [19,29]. This treatment is justified by the fact that although the woman is edematous during PE, it is vascular empty which is responsible for the occurrence of functional AKF notified above.…”

Risk factors and poor prognostic factors of preeclampsia in Ibn Rochd University Hospital of Casablanca: about 401 preeclamptic cases

“…The frequency of preeclampsia in Casablanca is 7.07%. Moroccans studies noted a variable rate between frequencies found in other cities ranging from 50 to 73% [15]. Therefore, this rate was 44% in sub-Saharan countries 44% [13], compared with developed countries that reported a frequency of 0.5-7% [3, 10, 11].…”