6 Acute renal failure in pregnancy

Pertuiset, Nathalie; Grünfeld, Jean‐Pierre

doi:10.1016/s0950-3552(05)80324-4

Cited by 56 publications

(15 citation statements)

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“…In one lactating bitch, acute renal failure developed shortly after parturition. In humans bilateral renal cortical necrosis is linked with pregnancy-associated hypertension 25 but no such association has been made in the dog nor could this be demonstrated in our patient. In two cats in which an underlying cause of the renal failure was not determined acute decompensation of preexisting renal failure was suspected as a diffuse, heterogeneous increase in renal echogenicity and loss of corticomedullary differentiation was present that was considered suggestive of chronic nephritis.…”

Section: Discussioncontrasting

confidence: 65%

Perirenal Effusion in Dogs and Cats With Acute Renal Failure

Holloway

O’Brien

2007

Vet Radiology Ultrasound

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Perirenal fluid accumulation has been described as an ultrasonographic feature of urine leakage, hemorrhage, abscessation, or neoplasia. The purpose of this retrospective study was to report perirenal effusion as an additional ultrasonographic finding in canine and feline patients with acute renal failure. The causes of acute renal failure in 18 patients included nephrotoxicity (4), leptospirosis (3), ureteral obstruction (2), renal lymphoma (2), ureteronephrolithiasis (2), prostatic urethral obstruction (1) and interstitial nephritis and ureteritis (1). An underlying cause was not identified in three patients. The sonographic finding of perirenal fluid was bilateral in 15 patients. Unilateral perirenal fluid was identified ipsilateral to the site of ureteric obstruction in two patients. Large effusions extended into the caudal retroperitoneal space. Additional sonographic findings suggestive of renal parenchymal disease included mild (5), moderate (5) or severe (2) pyelectasia, increased renal echogenicity (11), increased (9) or decreased renal size (2) and ureteral and/or renal calculi (3). There did not appear to be an association between the volume of perirenal fluid and the severity of renal dysfunction. All patients with large effusions underwent euthanasia. Perirenal fluid developing in acute renal failure is thought to be an ultrafiltrate associated with tubular back-leak into the renal interstitium that overwhelms lymphatic drainage within the perirenal and retroperitoneal connective tissues although obstruction to urine flow may also play a role. Localized perirenal retroperitoneal free fluid may be a useful ultrasonographic feature to assist with the characterization of, and determination of prognosis in, patients with suspected renal disease.

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Section: Discussioncontrasting

confidence: 65%

Perirenal Effusion in Dogs and Cats With Acute Renal Failure

Holloway

O’Brien

2007

Vet Radiology Ultrasound

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“…Its incidence is less than 1:20000 of all gestations 34. Statistics from other developing countries showed that pregnancy related acute renal failure (PRARF) were in Bangladesh, Nigeria, Ethopia and Pakistan, 11%, 25.7%, 55.0% and 18% respectively 2567.…”

Section: Discussionmentioning

confidence: 96%

Acute renal failure in pregnancy: Tertiary centre experience from north Indian population

et al. 2013

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Background:Obstetrical acute renal failure ARF is now a rare entity in the developed countries but still a common occurrence in developing countries. Delay in the diagnosis and late referral is associated with increased mortality. This study aimed to evaluate the contributing factors responsible for pregnancy-related acute kidney failure, its relation with mortality and morbidity and outcome measures in these patients.Materials and Methods:Total 520 patients of ARF of various aetiology were admitted, out of these 60 (11.5%) patients were pregnancy-related acute renal failure.Results:ARF Acute renal failure occurred in 32 (53.3%) cases in early part of their pregnancy, whereas in 28 (46.7%) cases in later of the pregnancy. Thirty-two (53.3%) patients had not received any antenatal visit, and had home delivery, 20 (33.4%) patients had delivered in hospitals but without antenatal care and eight (13.3%) patients received antenatal care and delivered in the hospitals. Anuria was observed in 23 (38.3%) cases, remaining 37 (61.7%) cases presented with oliguria. Septicemia was present in 25 (41.7%), hypertensive disorder of pregnancy in 20 (33.3%), haemorrhage in eight (13.3%), abortion in 5 (8.3%), haemolysis elevated liver enzymes low platelets counts (HELLP) syndrome in one (1.67%) and disseminated intravascular coagulation in one (1.67%). (61.7%) patients were not dialyzed, 33 (55%) recovered normal renal function with conservative treatment. Complete recovery was observed in 45 (75%) patients, five (8.4%) patients developed irreversible renal failure. Maternal mortality was nine (15%) and foetal loss was 25 (41.7%).Conclusion:Pregnancy-related ARF is usually a consequence of obstetric complications; it carries very high morbidity and mortality.

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“…Acute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates [2]. The incidence of acute renal failure during pregnancy has declined in both developed and developing countries [3, 4]. Compared with developed countries, China’s maternal mortality rate is relatively high [5].…”

Section: Introductionmentioning

confidence: 99%

Acute kidney injury during pregnancy and puerperium: a retrospective study in a single center

Huang

Chen

2017

BMC Nephrol

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BackgroundAcute kidney injury (AKI) is rare in women during pregnancy and puerperium, however, it is related to increased morbidity and mortality rates.ObjectiveThe aim of this study was to investigate the incidence, characteristics, and outcomes of AKI during pregnancy and puerperium in a Chinese population.MethodsIn this study, pregnant women discharged from hospital between January 2008 and June 2015 were screened. AKI was defined if the level of serum creatitine >70.72umol/l in pregnant women without chronic kidney disease (CKD). Acute-on-CKD was defined as a 50% increase in the level of serum creatinine vs baseline in patients with pre-existed CKD.ResultsWe reported a high incidence (0.81%) of AKI during pregnancy and puerperium. Three hundred and forty-three cases of AKI during pregnancy and puerperium included 21 severe AKI cases and 21 cases with acute-on-CKD. Pre-eclampsia/eclampsia, and postpartum hemorrhage were the most frequent causes of AKI during pregnancy and puerperium. About 17% women with pre-eclampsia/eclampsia and 60% women with HELLP syndrome complicated with AKI. The maternal outcome was good except in the setting of amniotic fluid embolism or hemorrhagic shock, whereas the prenatal outcome was relatively poor. Among the 14 death cases, 7 cases received renal replacement therapy. Amniotic fluid embolism and postpartum hemorrhage were the major causes of death in pregnant women with AKI.ConclusionAKI during pregnancy and puerperium is not as rare as we thought. Pre-eclampsia/eclampsia is the most common cause of AKI during pregnancy and puerperium, however, the outcome of pre-eclampsia-related AKI is good. Amniotic fluid embolism and postpartum hemorrhage are the leading causes of maternal mortality. Severe AKI may predict poor outcome.Electronic supplementary materialThe online version of this article (doi:10.1186/s12882-017-0551-4) contains supplementary material, which is available to authorized users.

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6 Acute renal failure in pregnancy

Cited by 56 publications

References 51 publications

Perirenal Effusion in Dogs and Cats With Acute Renal Failure

Perirenal Effusion in Dogs and Cats With Acute Renal Failure

Acute renal failure in pregnancy: Tertiary centre experience from north Indian population

Acute kidney injury during pregnancy and puerperium: a retrospective study in a single center

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