Introduction:
PREGNANCY-RELATED ACUTE KIDNEY INJURY (PR-AKI) IS A SERIOUS AND LIFE-THREATENING COMPLICATION DURING PREGNANCY, LABOR, OR THE POSTPARTUM PERIOD. WHILE ITS INCIDENCE HAS DECREASED IN DEVELOPED COUNTRIES, IT REMAINS A MAJOR CAUSE OF MATERNAL AND FETAL MORBIDITY AND MORTALITY IN LOW- AND MIDDLE-INCOME COUNTRIES. IN THESE REGIONS, PR-AKI IS PRIMARILY ASSOCIATED WITH SEPSIS, HEMORRHAGE, AND PREECLAMPSIA/ECLAMPSIA, WITH MATERNAL MORTALITY RATES RANGING FROM 13% TO 24% IN SEVERE CASES.
Methods:
MATERIALS AND METHODS: A CROSS-SECTIONAL STUDY WAS CONDUCTED COMPRISING 70 PATIENTS WITH PR-AKI ENROLLED FROM JANUARY 2023 TO JUNE 2024. DATA WERE COLLECTED USING A PRE-STRUCTURED PROFORMA, AND THE STUDY ADHERED TO ETHICAL GUIDELINES.
THIS STUDY AIMS TO INVESTIGATE THE PREVALENCE, ETIOLOGY, AND FETO-MATERNAL OUTCOME OF PR-AKI AT A TERTIARY CARE HOSPITAL, AND TO IDENTIFY FACTORS CONTRIBUTING TO IT IN ORDER TO REFORM PREVENTIVE AND MANAGEMENT STRATEGIES.
INCLUSION CRITERIA INCLUDED PREGNANT AND POST-PARTUM WOMEN WITH AKI AS PER KIDNEY DISEASE IMPROVING GLOBAL OUTCOMES (KDIGO) GUIDELINES 2022.
EXCLUSION CRITERIA ENCOMPASSED PATIENTS WITH KNOWN CASE OF CHRONIC KIDNEY DISEASE, AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE, KIDNEY STONE, PREEXISTING DIABETES MELLITUS/ HYPERTENSION, RENAL TRANSPLANT RECIPIENTS, RECENT HISTORY OF UROLOGICAL INTERVENTION OR THOSE UNWILLING TO PARTICIPATE. STATISTICAL ANALYSIS WAS PERFORMED USING SPSS VERSION 25.0.
Results:
THE MAJORITY OF PARTICIPANTS WERE AGED 25–30 YEARS, WITH 42.86% HAVING EDUCATION UP TO THE 8TH STANDARD AND 67.14% FROM LOW SOCIOECONOMIC STATUS. THE MOST COMMON RISK FACTOR WAS SEPSIS (67.14%), FOLLOWED BY ECLAMPSIA (14.28%) AND HELLP SYNDROME (9.52%). THE PRIMARY ETIOLOGY OF PR-AKI WAS PRERENAL CAUSES (41.43%). THE MODE OF DELIVERY WAS PREDOMINANTLY CAESAREAN SECTION (61.43%), WITH 62.86% OF NEONATES HAVING LIVE BIRTH. THE STUDY FOUND THAT 60% OF PATIENTS EXPERIENCED COMPLETE RENAL RECOVERY, WHILE 35.71% REQUIRED MAINTENANCE HEMODIALYSIS, AND 4.29% DIED.
Conclusions:
PR-AKI REMAINS A CRITICAL PUBLIC HEALTH ISSUE IN CENTRAL INDIA, WITH SEPSIS AND PRE-RENAL CAUSES BEING SIGNIFICANT CONTRIBUTORS. THE STUDY HIGHLIGHTS THE NEED FOR ENHANCED INFECTION CONTROL AND MANAGEMENT OF HYPERTENSIVE DISORDERS DURING PREGNANCY. WHILE MOST PATIENTS ACHIEVED COMPLETE RENAL RECOVERY, A CONSIDERABLE NUMBER REQUIRED HEMODIALYSIS, AND THERE WAS A NOTABLE MORTALITY RATE. THESE FINDINGS UNDERSCORE THE IMPORTANCE OF IMPROVING EARLY DIAGNOSIS AND TREATMENT STRATEGIES TO MITIGATE THE IMPACT OF PR-AKI ON MATERNAL AND FETAL HEALTH.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.