Hospital Outcomes of Obstetrical-Related Acute Renal Failure in a Tertiary Care Teaching Hospital

Abstract

Management of obstetrical acute renal failure remains a challenging task. We present data of 100 cases of obstetrical -related acute renal failure of 3-year duration (2007–2009) from Department of Nephrology & Hypertension, Lady Reading Hospital, Peshawar, Pakistan. The study is aimed to look at overall mortality and relationship of oliguria/anuria at presentation to dialysis dependency and renal cortical necrosis (RCN). Evaluation of comorbidity to dialysis dependency and RCN was also considered. While 91 patients required hemodialysis, 9 were managed conservatively; 57 were dialysis dependent whereas 43 remained dialysis independent on discharge; 47 patients had oliguria, 30 had anuria, and 23 had an output of >800 mL per 24 h on admission. RCN was seen in 30 cases, all biopsy confirmed; among these, 26 cases (86.67%) were associated with oliguria/anuria and dialysis dependency right from the beginning (p < 0.0001). However, four (13.33%) with RCN had output >800 mL per 24 h but remained dialysis dependent. Our data showed that out of 30 patients who presented with anuria, only 10 patients (33.33%) were dialysis independent on discharge, whereas out of 47 oliguric patients, 21 patients (44.6%) were dialysis independent upon discharge. Thus dialysis dependency does not correlate with anuria or oliguria at presentation (p = 0.133). Mortality of 7% was recorded; 23% were discharged with normal renal function. Septicemia, operative interventions, retained product of conception, post-partum hemorrhage, and RCN remained important comorbid conditions with regard to survival and dialysis dependency.

• Acute renal failure
• renal cortical necrosis
• oliguria
• anuria
• dialysis

ACKNOWLEDGMENTS

The authors acknowledge Dr. Anjum Mehmood for her endless efforts during the process of manuscript preparation. Efforts of Dr. Saadia Izzat during the process of data extraction are also acknowledged.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.