QUALITY OF LIFE RECOVERY IN PREGNANCY-RELATED ACUTE KIDNEY INJURY: INSIGHTS FROM A 12-MONTH FOLLOW-UP STUDY

Introduction:

Pregnancy-related acute kidney injury (PRAKI) is a severe complication that can have long-term implications on maternal health, both physically and emotionally. Understanding the recovery trajectory and quality of life (QOL) in women who have experienced PRAKI is crucial for guiding postpartum care and interventions. 

The aim of this study was to assess the quality of life (QOL) in women who experienced pregnancy-related acute kidney injury (PRAKI) over a 12-month period, by using the SF-36 questionnaire.

Methods:

A total of 100 women were initially enrolled in this Prospective Observational Study, of which 9 deaths occurred, resulting in a sample of 91 women assessed over a 12-month period. Written and informed consents were taken from all patients enrolled in the study. Institutional ethical committee approval was obtained. All PRAKI patients were assessed using the SF-36 quality of life questionnaire, covering eight domains (Physical Functioning, Role Physical, Role Emotional, Energy, Emotional Well-being, Social Functioning, Pain, and General Health), at baseline 0 months, 3 months, and 12 months. Mean scores and standard deviations were calculated, and paired t-tests were used to assess statistical significance between baseline and 1 year.

Results:

The analysis showed significant improvements in QOL across all SF-36 domains between baseline and 3 months postpartum. The most notable improvements were observed in Physical Functioning (mean score increased from 32.72 to 52.66, P < 0.001), Role Physical (31.08 to 46.90, P < 0.001), and Energy (28.64 to 51.66, P < 0.001). Emotional recovery was also prominent, with Role Emotional scores improving from 28.18 to 50.32 (P < 0.001), and Emotional Well-being from 31.69 to 48.76 (P < 0.001).

Though there was significant improvement in domain functioning by 3 months, the comparison between 3 and 12 months showed a plateau, with no further statistically significant improvement in any domain. Physical Functioning scores slightly decreased from 52.66 to 49.97, and General Health remained stable at 50.12 to 50.06 (P > 0.95 for all domains). Renal replacement therapy was required in 77% of the patients. Overall, there was a notable lack of further improvement in QOL at 12 months, indicating that despite initial gains, the long-term recovery was limited.

Conclusions:

The study demonstrates that women recovering from PRAKI experience significant improvements in quality of life within the first 3 months postpartum. The improvement was statistically significant in those with positive pregnancy outcome, family support and higher education. However, the plateau in recovery from 3 to 12 months highlights the need for sustained interventions beyond the early recovery phase and including a trained counsellor may be a value addition to post-partum care for ensuring optimal long-term maternal health outcomes. Ours is the first study to assess QOL among Pregnancy-Related Acute Kidney Injury (PRAKI) patients.

I have no potential conflict of interest to disclose.

I did not use generative AI and AI-assisted technologies in the writing process.