Abstract

VIZCARRA-VIZCARRA, Cristhian; HURTADO-ARESTEGUI, Abdías  and  GONZALES POLAR-GARCES, José. Acute kidney injury during pregnancy: experience in a general hospital in Arequipa - Peru: 2003 - 2013. Acta méd. Peru [online]. 2016, vol.33, n.3, pp.195-201. ISSN 1728-5917.

Background: Acute kidney injury (AKI) during pregnancy is a complication leading to maternal mortality risk. Objectives: To determine the clinical and laboratory characteristics of pregnant women with AKI (P-AKI). Methods: A descriptive study was carried out in Honorio Delgado Regional Hospital in Arequipa, Peru. All pregnant women diagnosed with AKI during the 2003 - 2013 period were included. Results: Sixty five patients were assessed, and the annual frequency of P-AKI was 6.5 cases/year. Twenty percent of P-AKI cases occurred in the first 20 weeks, 13.9% after miscarriage and 80% after 20 weeks; 52.3% occurred because of preeclampsia/Hellp syndrome. The average age of affected patients was 27.9 ± 7.4 years, sepsis was more frequent in the first 20 weeks of pregnancy (77 vs. 19%, p<0.0001), as well as lower potassium levels (3.2 ± 0.96 vs. 3.96 ± 1.15 mEq/L, p<0.03). After 20 weeks, patients with P-AKI had lower platelet counts (163,545 ± 107,547 vs. 98,978 ± 82,784 mm3, p<0.02) and higher ALT levels (20 ± 21 vs. 155 ± 27 U/L, p<0.0001). Nearly 14% of patients died (13.8%) and they also had higher creatinine (2.63 ± 2.3 vs. 4.75 ± 5.16, p= 0.04), pCO2 (27 ± 17 vs. 50 ± 28, p=0.001), and LDH levels (2099 ± 1903 vs. 4153 ± 1525, p= 0.02) and lower pH values (7.29 ± 0.17 vs. 7.09 ± 0.2, p= 0.002). The mortality rate was higher up to 20 weeks of pregnancy (30.7 vs. 9.6%; OR: 4.17; 95% CI: 0.93-18.64, p= 0.07). Conclusions: AKI during pregnancy is mainly caused by miscarriage and preeclampsia/HELLP syndrome before and after 20 weeks of pregnancy, respectively; and one out of seven pregnant women affected dies because of this condition

Keywords : Renal insufficiency; Pregnancy; Pre-eclampsia; HELLP syndrome.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )