Introduction:
Mortality rate of AKI can vary from 10-60%. Pregnancy-related Acute kidney injury (AKI) contributes to about 15% of maternal mortality and 10-30% progressing to End stage renal disease (ESRD). However, no comparative studies between obstetric and non-obstetric AKI exists. This study aims to compare the outcomes of obstetric and non-obstetric AKI with short-term follow-up until day 90.
Methods:
This prospective observational comparative study was conducted over 15 months, enrolling 260 cases. There were two groups: non-obstetric AKI and obstetric AKI. Inclusion criteria: Non-obstetric group - Age >18 years with AKI; Obstetric group - Age >18 years, pregnant or up to 42 days postpartum with AKI. AKI was defined as per KDIGO criteria. Patients with known Chronic kidney disease (CKD) or transplant were excluded. Baseline demographics and clinical profiles were compared. Relevant investigations and Kidney biopsy were performed to find out etiology. All were followed at days 7, 30, and 90 to assess complete recovery, dialysis dependency, progression to CKD and mortality.
Results:
A total of 260 AKI patients were enrolled, with 83.4% in non-obstetric group and 16.6% in obstetric group. Sepsis was the most common cause of AKI (51.5%), affecting 47.7% of the non-obstetric and 74.4% of the obstetric group. Renal biopsies, performed in 12.3% of cases, most showed acute tubular injury, followed by glomerular diseases such as non-proliferative Glomerulonephritis (GN), lupus nephritis, ANCA-associated GN, IgA nephropathy, and Membranoproliferative GN. In obstetric AKI, acute cortical necrosis and Thrombotic microangiopathy were common biopsy findings. At the 3-month follow-up, complete recovery was higher in the non-obstetric group (40.5% vs. 33.3%), while progression to CKD and dialysis dependency were higher in the obstetric group. Mortality at 3 months was higher in the non-obstetric group (50.4% compared to 33.3%), likely due to delayed presentation and greater severity at the time of presentation.
Conclusions:
At 3 months, mortality was higher in the non-obstetric group, while the obstetric group had greater progression to CKD and dialysis dependency. Early identification of AKI and comprehensive post-AKI care for high-risk patients are crucial for managing the long term outcomes.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.