Acute kidney injury related to pregnancy in developing countries: etiology and risk factors in an intensive care unit

Bentata, Y.; Housni, Brahim; Mimouni, Ahmed; Azzouzi, A.; Abouqal, Rédouane

doi:10.5301/jn.5000058

Cited by 58 publications

(55 citation statements)

References 24 publications

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“…A serum creatinine level higher than 1 mg/dL on admission predicted death with a sensitivity of 72% and a specificity of 66%. Our mortality is lower than that reported by Bentata et al 19 and Goplani et al…”

Section: Discussioncontrasting

confidence: 55%

“…Moreover, the onset of acute renal failure was significantly associated with several metabolic disturbances, particularly a decreased serum bicarbonate levels and increased serum potassium levels. Bentata et al 19 reported that patients with PRARF had higher rate of hypotension, icterus, hyperuricemia, thrombocytopenia and hepatic cytolysis which can be explained by higher incidence of HELLP syndrome, DIC and abruption placenta as leading causes for ICU admission in this group of patients.…”

Section: Discussionmentioning

confidence: 99%

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Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit

et al. 2013

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To describe the epidemiologic features of acute renal failure related to pregnancy (PRARF) and to evaluate its prognostic impact. Methods: Retrospective study conducted in a Tunisian intensive care unit over a period of 17 years (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). Women were included if they were more than 20 weeks pregnant and were admitted to the ICU during pregnancy or immediately (57 d) post partum. PRARF was defined by a serum creatinine level 40.8 mg/dL and was classified as mild (0.9 to 1.4 mg/dL), moderate (1.5 to 2.9 mg/dL) or severe (43 mg/dL). Results: Five hundred and fifty patients were included. Mean age was 31 AE 6 years. Mean SOFA score was 4 AE 3. PRARF was diagnosed in 313 patients (56.9%). ARF was mild in 215 cases (39.1%), moderate in 65 cases (11.8%) and severe in 33 cases (6%). Main causes leading to this complication were preeclampsia (66.5%) and acute hemorrhage (27.8%). Only two patients (0.4%) developed chronic renal failure and needed long-term dialysis. Patients who developed this complication had higher SOFA score (4.7 AE 3.5 vs. 3.2 AE 2.1; p50.001). Thirty-three patients (6%) died in the ICU. The rate of ICU mortality was significantly higher in patients with PRARF (9.3 vs. 1.7%; p50.001). Conclusions: PRARF is associated with higher mortality. Thus, appropriate monitoring of pregnancies is needed in order to prevent its onset by an early and prompt management of the underlying risk factors.

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Section: Discussioncontrasting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit

et al. 2013

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“…[51][52][53] Within developing world regions, causes can include toxicity from herbal treatments and complications during perinatal events. [54][55][56] Again, the relationship between AKI episodes and CKD progression highlights the importance of early CKD detection to increase the likelihood of protecting remaining kidney function from such events.…”

Section: Ckd Progressionmentioning

confidence: 99%

Maintenance Dialysis throughout the World in Years 1990 and 2010

Thomas

Wulf

Bikbov

et al. 2015

Journal of the American Society of Nephrology

169

137

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Rapidly rising global rates of chronic diseases portend a consequent rise in ESRD. Despite this, kidney disease is not included in the list of noncommunicable diseases (NCDs) targeted by the United Nations for 25% reduction by year 2025. In an effort to accurately report the trajectory and pattern of global growth of maintenance dialysis, we present the change in prevalence and incidence from 1990 to 2010. Data were extracted from the Global Burden of Disease 2010 epidemiologic database. The results are on the basis of an analysis of data from worldwide national and regional renal disease registries and detailed systematic literature review for years 1980-2010. Incidence and prevalence estimates of provision of maintenance dialysis from this database were updated using a negative binomial Bayesian metaregression tool for 187 countries. Results indicate substantial growth in utilization of maintenance dialysis in almost all world regions. Changes in population structure, changes in aging, and the worldwide increase in diabetes mellitus and hypertension explain a significant portion, but not all, of the increase because increased dialysis provision also accounts for a portion of the rise. These findings argue for the importance of inclusion of kidney disease among NCD targets for reducing premature death throughout the world.

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“…However, pregnancy is a risk factor in 15 to 20% of cases of ARI (acute renal injury) in developing countries [4] , and the incidence rate varies widely, between 4% and 36% depending on the study [5] . Acute renal injury is often evident in conditions like severe pre-eclampsia [6,7] , HELLP syndrome [8] and acute fatty liver during pregnancy, in addition to numerous obstetric complications such as antepartum and postpartum haemorrhage [9] as well as associated infectious processes [10][11][12] , which can range from a subclinical state to need for permanent dialysis [13] . Acute renal failure is defined as an increase of 0.3mg/dl of creatinine or an increase of 1.5 times with respect to the base level, or a decreased urine output below 0.5 cc/kg/hr for six hours [8] .…”

Section: Introductionmentioning

confidence: 99%

Injuria renal aguda en gestantes de la Unidad de Cuidado Intensivo del Hospital Universitario de Neiva, periodo 2010-2012

Cortes

Garay

Rojas

et al. 2014

RFS

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Los esfuerzos en el tratamiento de pacientes obstétricas, están dirigidos a la disminución de la morbimortalidad, con resultados favorables al término de la gestación, disminuyendo el riesgo de complicaciones, desarrollo de enfermedades crónicas o posibles secuelas para la madre y el producto; esta es la importancia de determinar la presentación de injuria renal aguda en pacientes obstétricas gravemente enfermas atendidas en la unidad cuidado intensivo gineco-obstétrico del Hospital Universitario de Neiva. Se desarrolló un estudio descriptivo, retrospectivo, tipo de serie de casos, se encontró que el 47,8%, eran primigestantes, y el 11,7% presentaron injuria renal aguda, con una edad promedio de 25,3 años IC 95%, con diagnóstico previo de alto riesgo obstétrico (ARO) en el 52,2%. La edad gestacional promedio fue de 35,6 semanas IC 95%, predominando la preeclampsia severa en el 34%, clasificadas como AKIN 1 en el 48,7%, oliguricas en el 23,9%, el 13% del requirió hemodiálisis y la muerte fue el desenlace en el 4,3%. Se establece de esta forma, la importancia de seguimientos continuos a las primigestantes jóvenes, alto riesgo obstétrico, en el tercer trimestre del embarazo o en puerperio inmediato, hospitalizadas en unidad de cuidados intensivos con alteración del valor de creatinina, los volúmenes urinarios y diagnóstico de preeclampsia severa.

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Acute kidney injury related to pregnancy in developing countries: etiology and risk factors in an intensive care unit

Cited by 58 publications

References 24 publications

Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit

Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit

Maintenance Dialysis throughout the World in Years 1990 and 2010

Injuria renal aguda en gestantes de la Unidad de Cuidado Intensivo del Hospital Universitario de Neiva, periodo 2010-2012

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