Patients with Postpartum Acute Kidney Injury: Clinico-Etiological Profile.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2019, Vol 4, Issue 5
Abstract
Background: Acute kidney injury (AKI) is one of the most challenging and serious complications of pregnancy. It is associated with significant morbidity and mortality in young and often otherwise healthy women. The reported incidence of pregnancy related AKI in the developed countries is 1 to 2.8% while in developing countries it is between 9 to 25%. Acute kidney injury is more often due to pregnancy related diseases. Materials and Methods: The present observational study was conducted in the Postgraduate Department of Medicine at SMHS Hospital an associated hospital of Government Medical College Srinagar over a period of two years. The study was done to study the clinico-etiological profile of patients with postpartum acute kidney injury and to evaluate the outcome at the end of 3 months of patients with postpartum AKI. After obtaining written informed consent and ethical clearance from Institutional Ethical Committee, patients who developed acute kidney injury in the postpartum period were analysed and statistical analysis was done using Medicalc version 17. Results: The total number of deliveries conducted in these two years were 36550 which includes 21930 lower segment caesarean section and 14620 normal vaginal deliveries out of which 143 patients were admitted as postpartum acute kidney injury. Out of 143 patients maximum patients were in the age group of 20-24 years (57%) and 63.6% belonged to rural background. In our patients of AKI the value of mean Creatinine was 6.9+3.89mg/dl with maximum of 22.9mg/dl and minimum of 2.4mg/dl. 67.1% of patients had normal sized kidney. On USG abdomen out of 143 patients admitted (11.2%) patients underwent renal biopsy to look for cause of AKI, 50% of biopsied patients had cortical necrosis and 12.5% had vasculitis. Conclusion: the study shows that the most common cause of postpartum AKI is sepsis including septic shock and urosepsis followed by postpartum haemorrhage, pregnancy induced hypertension and antepartum haemorrhage. 50 percent of biopsied patients had cortical necrosis and 25% had acute tabular necrosis. It is quite clear that by better health care facilities, proper referral to the tertiary care centre, avoidance of unnecessary drugs and early diagnosis lead to better outcome.
Authors and Affiliations
Dr. Omar Farooq
Keywords
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