Acute kidney injury in pregnancy—a single center experience

Figures & data

Figure 1. Time period of occurrence of PRAKI.

Table 1. Clinical profile of patients.

Features	Number (%)
Clinical symptoms
Edema	76 (58)
Oliguria	85 (66)
Anuria	14 (11)
Fever	45 (35)
Jaundice	12 (9)
Seizures	7 (5)
Hematuria (>3 RBCs/hpf)	12 (9)
Nephrotic proteinuria (>3.5 g/day)	15 (2)
Anemia (<10 g/dL)	21 (6)
Thrombocytopenia	38 (29)
Leucocytosis (>12,000/cu.mm)	33 (25)
Hyperbilirubinemia (bilirubin >2 mg/dL)	12 (9)
Disseminated intravascular coagulation	29 (22)
Laboratory parameters	Mean value
Sr. creatinine at presentation (mg/dl)	2.59
Peak sr. creatinine (mg/dL)	5.08
Proteinuria (g/day)	1.43

Table 2. Etiology and renal biopsy findings.

Features	Number of patients (%)
Etiology	N = 130
Sepsis	51 (39)
Pre-eclampsia/eclampsia	27 (21)
Abruption Placentae	13 (10)
Acute diarrheal disease	13 (10)
Thrombotic microangiopathy	11 (9)
Lupus nephritis	4 (3)
Postpartum hemorrhage	3 (2)
Others	8 (6)
Renal biopsy	N = 46
Cortical necrosis	16
Thrombotic microangiopathy	11
Acute tubular injury	9
Acute tubulointerstitial nephritis	1
Glomerular disease
Lupus nephritis	4
IgA nephropathy	1
Diffuse mesangial proliferation	1
Focal segmental glomerulosclerosis	1
Pauci-immune necrotising GN	1
Infection-related GN	1

Table 3. Maternal renal, fetal and obstetric outcomes.

Outcome	Number (%) N = 130
Maternal renal outcome
Complete recovery	73 (56)
Progression to Chronic kidney disease	46 (35)
End stage renal disease	1 (1)
Death	10 (8)
Fetal outcome
Live baby	55 (42)
Intra-uterine growth retardation	5 (4)
Adverse fetal outcome (intra-uterine death + still birth)	70 (54)
Obstetric outcome
Vaginal delivery	44 (34)
Cesarean section	57 (43)
Abortion, intrauterine death	29 (23)

Table 4. Risk factors for progression to CKD.

Variable	Recovered (n = 73)	Progressed to CKD (n = 47)	p-Value
Mean age (years)	25.5	24.8	0.48^a
Mean platelet count (lakh/cu.mm)	2.17	1.77	0.0001^a
Mean WBC count (cells/cu.mm)	12,868	14,436	0.38^a
Peak sr. creatinine (mg/dL)	4.5	6.38	0.0003^a
Dialysis dependency at presentation	46	40	0.0002^b
Cortical necrosis	4	12	0.0055^b
TMA	3	8	0.0117^b
Sepsis	24	19	1.02^b

Notes: WBC, white blood cells; TMA, thrombotic microangiopathy.

^aUnpaired t test.

^bFisher exact test.