Spectrum of Acute Cortical Necrosis in Indian Patients

Chugh, Kirpal S.; Singhal, Pravin C.; Kher, Vijay; Gupta, Vikash; Malik, G.H.; Narayan, Girish; Datta, B N

doi:10.1097/00000441-198307000-00002

Cited by 46 publications

(20 citation statements)

References 32 publications

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“…6 In another Indian study, obstetric causes were responsible for RCN in 35/49(71%) patients with 19 cases (39%) due to septic abortion and 16(33%) due to late pregnancy AKI. 4 We have earlier observed RCN in 15/ 63(23.8%) patients of obstetric AKI. 3 The reported frequency of RCN in India and Pakistan varies between 23 and 42.8% of all patients with obstetric AKI (Table 3).…”

Section: Discussionmentioning

confidence: 87%

“…1,5,13,14 However, the incidence is higher (3-7%) in developing countries. 2,4 It can be associated with a variety of conditions like sepsis, extensive burns, pancreatitis, snake bite and diabetic ketoacidosis; but the obstetric complications are the commonest causes of renal cortical necrosis (50-70%). [2][3][4]12 Renal cortical necrosis is one of the most severe complications of AKI in pregnancy.…”

Section: Discussionmentioning

confidence: 99%

“…2,4 It can be associated with a variety of conditions like sepsis, extensive burns, pancreatitis, snake bite and diabetic ketoacidosis; but the obstetric complications are the commonest causes of renal cortical necrosis (50-70%). [2][3][4]12 Renal cortical necrosis is one of the most severe complications of AKI in pregnancy. Septic abortion, postpartum hemorrhage, abruptio placentae, puerperal sepsis and intrauterine death (IUD) are the major causes (50-70%) of RCN in developing countries.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] It is an important cause of obstetric AKI, with disastrous sequelae. 4,5 Progression to end-stage renal disease is a rule in diffuse cortical necrosis. 5 Obstetric complications (septic abortion, puerperal sepsis, abruptio placentae, postpartum hemorrhage, and eclampsia) are the main (50-70%) causes of RCN in developing countries.…”

Section: Introductionmentioning

confidence: 99%

“…1,5 The reported incidence of RCN in P-AKI varies between 18 and 42.8% in different Indian studies. 3,4,6,[8][9][10][11] However, the overall incidence of RCN in P-AKI has decreased from 20-30% to 5% in the past two decades in developing countries. 12 The aim of present study was to evaluate the changing pattern of RCN in patients with obstetric AKI over the last three decades from a single centre.…”

Section: Introductionmentioning

confidence: 99%

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Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

et al. 2015

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Rational: Obstetrical complications are the commonest causes of Renal Cortical Necrosis (RCN). However, the overall incidence of RCN in obstetric acute kidney injury in developing countries has been decreasing in recent years. Objective: The aim of this study was to evaluate the changing profile of RCN in obstetric AKI over the last three decades. Methods: This single center study included patients with biopsy proven renal cortical necrosis over a period of 32 years from 1982 to 2014. The diagnosis of RCN was suspected in patients with prolonged AKI (44 weeks) with absolute anuria in the setting of hemorrhage, hypotension and sepsis; and was confirmed by renal biopsy. The changing pattern in the incidence, etiology and outcome of RCN in patients with obstetric AKI was compared in the three study periods, namely 1982-1991, 1992-2002 and 2003-2014. Results: Over a period of 32 years, RCN was diagnosed in 15/259(5.8%) cases of obstetric AKI. Diffuse and patchy cortical necrosis were noted in 8(53.3%) and 7(46.7%) patients, respectively. RCN occurred in 17%(11/65), 2.4%(3/125) and 1.44%(1/69) patients in 1982-1991, 1992-2002 and 2003-2014, respectively. Septic abortion was commonest cause of RCN in the first two study periods but no case was observed in last decade. The decrease in incidence of RCN over the three decades was statistically significant (p-value50.001). Maternal mortality decreased to zero in 2003-2014 from 72.7% in 1982-1991. Conclusions: The incidence of RCN in obstetric AKI in developing countries has declined low enough to label it as a disappearing entity.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

et al. 2015

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Acute Renal Failure in Pregnancy

Nk¹

1988

Arch Intern Med

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Prevalence and Determinants of Acute Renal Failure Following Cardiopulmonary Resuscitation

Mattana¹

1993

Arch Intern Med

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We conclude that acute renal failure occurs commonly in the postcardiac arrest period. Administration of the vasoconstrictor epinephrine, congestive heart failure, coronary artery disease, and preexisting renal insufficiency may be significant risk factors for the development of postcardiac arrest acute renal failure. The development of acute renal failure following cardiopulmonary resuscitation predicts a lesser likelihood of survival to discharge from the hospital.

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Spectrum of Acute Cortical Necrosis in Indian Patients

Cited by 46 publications

References 32 publications

Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

Renal cortical necrosis is a disappearing entity in obstetric acute kidney injury in developing countries: our three decade of experience from India

Acute Renal Failure in Pregnancy

Prevalence and Determinants of Acute Renal Failure Following Cardiopulmonary Resuscitation

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