Changing picture of acute kidney injury in pregnancy: Study of 259 cases over a period of 33 years
| Autor: | M Sivasankar, Laxminarayan Pandey, Jai Prakash, S Prakash, Pragya Pant, P K Doley, Usha Singh, Rubina Vohra |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
medicine.medical_specialty
030232 urology & nephrology 030204 cardiovascular system & hematology lcsh:RC870-923 urologic and male genital diseases Acute fatty liver of pregnancy Preeclampsia preeclampsia 03 medical and health sciences Hyperemesis gravidarum 0302 clinical medicine Renal cortical necrosis medicine CKD Pregnancy Eclampsia business.industry Obstetrics urogenital system Incidence (epidemiology) Acute kidney injury medicine.disease lcsh:Diseases of the genitourinary system. Urology female genital diseases and pregnancy complications Surgery cortical necrosis septic abortion Nephrology puerperal sepsis Original Article pregnancy business |
| Zdroj: | Indian Journal of Nephrology Indian Journal of Nephrology, Vol 26, Iss 4, Pp 262-267 (2016) |
| ISSN: | 1998-3662 0971-4065 |
| Popis: | The incidence of acute kidney injury (AKI) in pregnancy is declining in developing countries but still remains a major cause of maternal and fetal morbidity and mortality. The aim of the study was to analyze the changing trends in pregnancy related AKI (PR-AKI) over a period of thirty-three years. Clinical characteristics of PR-AKI with respect to incidence, etiology and fetal and maternal outcomes were compared in three study periods, namely 1982-1991,1992-2002 and 2003-2014. The incidence of PR-AKI decreased to 10.4% in 1992-2002, from 15.2% in 1982-1991, with declining trend continuing in 2003-2014 (4.68%).Postabortal AKI decreased to 1.49% in 2003-2014 from 9.4% in 1982-1991of total AKI cases. The AKI related to puerperal sepsis increased to 1.56% of all AKI cases in 2003-2014 from 1.4% in 1982-1991. Preeclampsia/eclampsia associated AKI decreased from 3.5% of total AKI cases in 1982-1991 to 0.54% in 2003-2014. Pregnancy associated - thrombotic microangiopathy and acute fatty liver of pregnancy were uncommon causes of AKI. Hyperemesis gravidarum associated AKI was not observed in our study. Incidence of renal cortical necrosis (RCN) decreased to 1.4% in 2003-2014 from 17% in 1982-1991.Maternal mortality reduced to 5.79% from initial high value 20% in 1982-1991. The progression of PR-AKI to ESRD decreased to1.4% in 2003-2014 from 6.15% in 1982-1991. The incidence of PR-AKI has decreased over last three decades, mainly due to decrease in incidence of postabortal AKI. Puerperal sepsis and obstetric hemorrhage were the major causes of PR-AKI followed by preeclampsia in late pregnancy. Maternal mortality and incidence and severity of RCN have significantly decreased in PR-AKI. The progression to CKD and ESRD has decreased in women with AKI in pregnancy in recent decade. However, the perinatal mortality did not change throughout study period. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|