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

Figures & data

Table 1. Biological findings on admission in ICU.

Parameter	Number	Mean	Standard deviation
Sodium (mmol/L)	548	136	5
Potassium (mmol/L)	548	3.9	0.7
pH	537	7.36	0.12
PaO2 (mmHg)	537	132	55
PaCO2 (mmHg)	537	37.2	2.6
Bicarbonates (mmol/L)	537	18.4	4.4
SaO2 (%)	537	98.2	5.3
Leucocytes (/mm^3)	550	16,030	7153
Hemoglobin (g/dL)	550	9.8	2.5
Hematocrit (%)	550	29	7
Platelets (G/L)	550	135	93.6
Prothrombine rate (%)	550	71	21
Fibrinogen (g/L)	550	3.7	2.5
DIC (%)	550	157	28.5
AST (UI/L)	307	98	180
ALT (UI/L)	307	64	99
Bilirubin	517	41.7	51.8

Notes: AST, aspartate aminotransferase; ALT, alanine aminotransferase; DIC, disseminated intravascular coagulation.

Figure 1. Evolution of the incidence of acute renal failure during from 1995 to 2011 in our intensive care unit.

Figure 2. Creatinine levels in patients with acute pregnancy-related acute renal failure.

Table 2. Etiology of obstetric acute renal failure.

Causes	N	%
Preeclampsia	208	66.5
Mild	140	44.8
Moderate	42	13.4
Severe	26	8.3
Acute bleeding	87	27.8
Mild	51	16.3
Moderate	19	6.1
Severe	17	5.4
HELLP syndrome	51	16.3
Mild	34	10.9
Moderate	14	4.5
Severe	3	0.9
AFL of pregnancy	24	7.7
Mild	6	1.9
Moderate	12	3.9
Severe	6	1.9
Sepsis	13	4.2
Mild	10	3.3
Moderate	2	0.6
Severe	1	0.3
Thrombotic microangiopathies	5	1.6
Mild	1	0.3
Moderate	0	0
Severe	4	1.3

Table 3. Comparison of PRARF (+) and PRARF (−) according to demographic characteristics.

Parameter	PRARF (+)	PRARF (−)	p
Age (years ± SD)	30.5 ± 6.3	30.8 ± 6.4	0.626
gestational age (weeks ± SD)	33.6 ± 5.2	34 ± 5.6	0.384
Primiparity (N/%)	159/55.8	105/44.3	0.131
Previous diabetes (N/%)	14/4.5	6/2.5	0.228
Previous valvular disease (N/%)	12/3.8	7/3	0.576

Table 4. Comparison of PRARF (+) and PRARF (−) according to biological findings on admission.

Parameter	PRARF (+)	PRARF (−)	p
pH (±SD)	7.36 ± 0.9	7.37 ± 0.2	0.433
PaCO2 (mmHg ± SD)	34 ± 11	39 ± 5	0.047
Bicarbonates (mmHg ± SD)	17.9 ± 4.5	19.1 ± 4.2	0.008
PaO2 (mmHg ± SD)	130.7 ± 56.2	134.3 ± 52.8	0.446
SaO2 (% ± SD)	99.1 ± 1.9	99.3 ± 1.6	0.702
Sodium (mmol/L ± SD)	135 ± 6	136 ± 5	0.328
Potassium (mmol/L ± SD)	4 ± 0.8	3.7 ± 0.6	<0.001
Leucocytes (/mm^3± SD)	16740 ± 7779	15094 ± 6123	0.006
Hemoglobin (g/dL ± SD)	9.7 ± 2.6	9.9 ± 2.3	0.207
Hematocrit (% ± SD)	28.8 ± 7.6	29.6 ± 6.6	0.173
Platelets (G/L ± SD)	134.8 ± 94.8	135.1 ± 92.2	0.965
Prothrombine rate (% ± SD)	69.5 ± 22.2	72.4 ± 19.9	0.11
Fibrinogen (g/L ± SD)	3.8 ± 2.9	3.4 ± 1.8	0.361
AST (UI/L ± SD)	116 ± 218	81 ± 134	0.089
ALT (UI/L ± SD)	73 ± 118	56 ± 77	0.135
Bilirubin (µmol/L ± SD)	45 ± 57	37 ± 43	0.047

Figure 3. ROC curve showing the correlation between serum creatinine level and ICU mortality (area under curve = 0.761).

Table 5. Prognosis impact of PRARF.

	Mild PRARF	Moderate PRARF	Severe PRARF	p
Duration of MV  (day ± SD)	2.8 ± 4.1	4.7 ± 4.1	7.8 ± 6.3	<0.001
LOS (day ± SD)	2.4 ± 3.3	4.3 ± 5.8	9.4 ± 7.1	<0.001
SAPSII ( ± SD)	20.5 ± 8.3	27.2 ± 12	38.8 ± 14.2	<0.001
SOFA ( ±SD)	4.2 ± 3	5.9 ± 2.2	12.4 ± 4.9	<0.001

Notes: MV, mechanical ventilation; LOS, length of ICU stay.