Pregnancy-related acute kidney injury: Etiologies and short-term outcomes in a tertiary hospital in Southwest Nigeria

Adejumo, OA; Akinbodewa, AA; Enikuomehin, OC; Lawal, Oluwafemi Oluwasegun; Abolarin, OS; Alli, O.A. Terry

doi:10.4103/1319-2442.275487

Cited by 13 publications

(17 citation statements)

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“…PR-AKI represented a major health problem with ominous outcomes in the studied countries. In Nigeria, the most populous African country and one of the six countries that collectively contribute to more than half of the total maternal deaths worldwide [ 33 ], Adejumo et al in their retrospective study reported maternal and fetal mortality rates of 34.4% and 50%, respectively, in women complicated by PR-AKI, with ICU admission, hypotension and impaired consciousness as the main reported associations [ 34 ]. In the aforementioned study, most cases presented in the post-partum period, with 75% of subjects requiring hemodialysis, however, 50% of patients fully recovered and only 3.1% became dialysis-dependent [ 34 ].…”

Section: Resultsmentioning

confidence: 99%

“…The most common presenting symptom for PR-AKI was oliguria/anuria [ 10 , 28 , 34 , 38 ]. A shared feature among women in African countries is the poor and inadequate antenatal care in addition to late referral of cases to specialized tertiary centers [ 10 , 27 , 28 , 34 , 38 ]. Kabbali et.…”

Section: Discussionmentioning

confidence: 99%

“…Hypertensive disorders of pregnancy (especially pre-eclampsia), obstetric hemorrhage and sepsis were the most common causes of PR-AKI in the included studies. Pre-eclampsia was the leading cause in nine studies [ 27 – 29 , 36 , 38 – 40 , 42 , 43 ], while obstetric hemorrhage was the leading cause in only two studies [ 10 , 34 ]. In the majority of studies, sepsis was the second most widespread cause of PR-AKI, either after pre-eclampsia or obstetric hemorrhage.…”

Section: Discussionmentioning

confidence: 99%

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Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Shalaby

Shemies

2022

J Nephrol

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Background Pregnancy-Related Acute kidney injury (PR-AKI) is a global health problem with substantial maternal and fetal morbidity and mortality. However, little is known about the current situation in the developing world including African countries. Africa is the poorest continent per capita, and women from Sub-Saharan Africa alone account for 66% of the estimated global maternal deaths from preventable obstetric causes. Methods Objective To review the literature on the clinical profile, maternal and renal outcomes of women with PR-AKI in the African continent. Search strategy Medline, ISI Web of Science, Scopus, and Cochrane library were searched in February 2022, using the MeSH terms and text key words: “pregnancy”, “pregnant”, “acute kidney injury”, “acute renal insufficiency”, “acute renal injury”, “acute renal failure”, and “Africa”. Selection criteria and data collection Studies from African countries which reported maternal and renal outcomes in women with PR-AKI during pregnancy or postpartum were included. Editorials, short communications, and case reports were excluded. The study quality was assessed using the NHLBI tool. Data extraction was done using predefined data fields. Results A total of 167 studies were evaluated, of which 14 studies from seven African countries met the inclusion criteria. Preeclampsia, obstetric hemorrhage, and sepsis represented the main causes of PR-AKI. Maternal mortality ranged between 0 and 34.4%. Although the majority of women needed ICU admission and hemodialysis, renal recovery occurred in 53.1–90% of patients. Perinatal mortality has been reported to be 1.5–60.5% in the included studies. Authors’ conclusions PR-AKI in Africa represents the second leading cause of AKI. Limited access to obstetric care, late referral, and late diagnosis of women with risks for PR-AKI hinder the curtailment of the problem. Provision of health care facilities with adequately trained personnel and implementation of preventive strategies will be of great value in decreasing the magnitude of the problem.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Shalaby

Shemies

2022

J Nephrol

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“… 5 , 14 , 16 The study population consisted of young women whose peak age was between 20 to 30 years, which was younger than those reported in Nigeria. 17 This difference could be explained by the religious and cultural differences between the population. Our study population’s young age could explain why 82.3% had no premorbid medical conditions.…”

Section: Discussionmentioning

confidence: 99%

Demographic Characteristics and Risk Factors Affecting the Development of Postpartum Acute Kidney Injury in Somalia: Single-Center Experience

Omar¹,

Osman²,

Hilowle³

et al. 2022

IJWH

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Background and Aim Although postpartum acute kidney injury (PPAKI) is declining in developing countries, it is still a leading cause of maternal and fetal morbidity and mortality. The study aimed to determine the causes, risk factors, and the outcomes of patients with postpartum acute kidney injury managed at Mogadishu Somali Turkey Training and Research Hospital, in Mogadishu, Somalia over a two years period. Methods This study was conducted retrospectively at Mogadishu Somali-Turkey Training and Research Hospital, Somalia’s largest teaching and referral hospital. During a two-year period (January 2020 to December 2021), we evaluated women who had acute kidney injury during the postpartum period and were hospitalized in our hospital. The data was also evaluated for postpartum admission day and hospital stay. The requirement for dialysis and the results were documented. Maternal outcomes are categorized as follows: Complete recovery after discharge/follow-up, chronic dependence on hemodialysis and death during admission. Results We studied 79 postpartum AKI patients. The mean age of the participants was 28.67 ± 6.14. Most patients (51%) were aged 20–30, followed by 30–40 (29%). According to self-reported comorbidities, most individuals had no history of chronic diseases, 8 (10.1%) had hypertension and 3 (3.8%) had heart failure, and DM and HTN 2(2.5%). The most common causes of PPAKI were eclampsia (24.1%), hemorrhagic shock, intrauterine mortality (16.5%), placenta abruptio and uterine rupture (8.9%). Hemorrhage (5.1%) and placenta previa (2.5%). The patient’s outcome was associated with age (p=0.04), platelet (p=0.024), and hospital stay (p=0.009). Conclusion Postpartum acute kidney injury is very common in underdeveloped nations. Preeclampsia/Eclampsia, obstetric bleeding, and intrauterine death are the leading causes of postpartum acute kidney injury in Somalia. This tragic scenario may be avoided by providing appropriate antenatal care and raising awareness among Somali women about the benefits of antenatal care provided by public institutions.

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“…La lesión renal aguda (LRA) se de ne como aquella pérdida abrupta de la función renal que resulta en la retención de urea y otros productos de desecho nitrogenados y está asociada a la desregulación del volumen extracelular y electrolitos [1]. Cuando este tipo de lesión ocurre durante el embarazo o puerperio se denomina LRA relacionada con el embarazo (Emb-LRA) [1], y aunque en la mayoría de estos casoslas causas son leves debido a motivos prerrenales como la depleción de volumen, otras causas como abortos sépticos o microangiopatías trombóticas (MAT) pueden ser potencialmente mortales y requieren tratamiento de diálisis urgente [2]. La Emb-LRA está asociada con resultados maternos y fetales adversos en términos de progresión a enfermedad renal en etapa terminal y aumento de la mortalidad materna, así como mayor incidencia de prematuridad y muerte perinatal [2,3].…”

Section: Introductionunclassified

Lesión renal aguda en la mujer embarazada

Robles¹,

Rico-Fontalvo

Daza-Arnedo

et al. 2020

Rev. Colomb. Nefrol.

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Aunque en la actualidad la lesión renal aguda en mujeres embarazadas es una complicación poco común, esta se correlaciona con peores desenlaces maternos y fetales. Sus causas son múltiples y varían según el trimestre de presentación. Los cambios fisiológicos renales durante el embarazo hacen que los criterios diagnósticos de lesión renal aguda en la población general no sean fácilmente extrapolables a las pacientes obstétricas, por lo que la sospecha temprana y eltratamiento oportuno son fundamentales para evitar la progresión del daño renal y sus complicaciones sistémicas asociadas, incluidas las metabólicas, urémicas e hidroelectrolíticas.

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Pregnancy-related acute kidney injury: Etiologies and short-term outcomes in a tertiary hospital in Southwest Nigeria

Cited by 13 publications

References 1 publication

Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Pregnancy-related acute kidney injury in the African continent: where do we stand? A systematic review

Demographic Characteristics and Risk Factors Affecting the Development of Postpartum Acute Kidney Injury in Somalia: Single-Center Experience

Lesión renal aguda en la mujer embarazada

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