Prevalence Rate of Acute Renal Failure in HELLP Syndrome: A Summary from a Single Country's Data
Dear Editors,
HELLP syndrome is an important but rare clinical syndrome in medicine that has been researched for fewer than 50 years.[Citation1–3] This syndrome consists of a complex of hemolysis, elevated liver enzymes, and low platelets in the pregnant with severe eclampsia, leading to a prompt parturition. An important complication of HELLP syndrome is acute renal failure, which might increase the difficulty in case management.[Citation1–3] The exact magnitude of acute renal failure in the case with HELLP syndrome is not well clarified. In this paper, the author tries to assess the prevalence rate of acute renal failure in HELLP syndrome. A case summarization technique on the published data was used. The focused reports were those on HELLP syndrome in Thailand. The author used the standard literature search by standard databases, PubMed, SciCitationIndex, and Scopus. Also, the local database, ThaiIndexMedus, was also searched. Prevalence of acute renal failure among the reported cases of HELLP syndrome from Thailand was calculated using basic descriptive statistical analysis.
According to the review, there are at least 7 reports[Citation4–10] on 38 cases of HELLP syndrome from Thailand. Among these 38 cases, there are 8 cases (21.1%) with acute renal failure. The demographical data, laboratory parameters, as well as the fatality rate of the cases with and without acute renal failure is not statistically different. Of interest, fewer than 50 cases of HELLP syndrome can be seen in Thai records, which reflects the rarity of this condition. (In general, this syndrome is forced to be reported due to the policy of Thai Ministry of Public Health.) However, up to one-fifth of these cases presented acute renal failure. However, the author can detect no significant difference in demographical data, and laboratory parameters between the cases with and without acute renal failure are not statistically different. Finally, based on the high proportion of acute renal failure in HELLP syndrome, the author hereby proposed a new syndrome HELLPAR (hemolysis, elevated liver enzymes, low platelets, and acute renal failure).
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