Acute Kidney Injury
Conditions
Keywords
AKI related to pregnancy, AKI, PRAKI, Pregnancy related AKI
Brief summary
The primary objective of this study is to identify characteristics of patient with PR AKI treated in Assiut university hospital Secondary outcomes: 1. Assessment of pregnancy related AKI maternal outcome (complete recovery , partial recovery or progress to ESRD) within 3 months duration 2. To identify predictors of unfavorable outcome of patient with pregnancy related AKI
Detailed description
Acute kidney Injury (AKI) is a syndrome which is characterized by an rapid deterioration of the kidney function , manifested by increase in serum creatinine level with or without reduced urine output and linked to high rate of morbidity and mortality .AKI is considered a major public health problem despite much improvmnent in heakth care and especially, most of them (about 85 %) in developing countries with low resources.Pregnancy related AKI ( PR -AKI ) is a major obstetric complication which may cause termination of pregnancy (TOP ), Intensive care unit ( ICU ) admission , need for dialysiy , both maternal and perinatal morbidity and mortality with maternal mortality rang from 9% to 55 % . PR-AKI has a major risk factors include preeclampsia which is the most common cause (15-20%) , hyperemesis gravidarum , acute fatty liver of pregnancy and placental abruption , puerperal sepsis and septic abortion .The maternal outcome of pregnancy related AKI include complete recovery with return of serum creatinine to normal (> 1.4 mg /dl ) about (40-75% ), partial recovery(4-9% require dialysis about 4 months after delivery) , progress to End stage renal disease (1.5 - 2.5 %) or maternal mortality . The maternal mortality rate (MMR) increases with increasing severity of pregnancy-related complications and can range from 13 to 24% in developing countries due to PR-AKI . Timely identification of patients and management of underlying conditions is considered the cornerstone to improve maternal outcome.
Interventions
None listed
Sponsors
Study design
Eligibility
Inclusion criteria
* Women (>18 years) who developed AKI with or without need for dialysis treatment during pregnancy, childbirth , post abortion period and /or puerperium * AKI as defined by KDIGO definition as follows: 1. Increase in serum creatinine > 0.3 mg/dl within 48 2. Increase in serum creatinine > 1.5 times baseline, which is known or presumed to have occurred within the prior 7 days. 3. urine volume of < .5 ml / kg / hours
Exclusion criteria
* Patients with preexisting kidney disease before pregnancy * Patients with AKI not related to pregnancy. * Patients with uncertain history for incident time of AKI. * Patients refuse to participate in the study
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| The occurance of renal recovery | After the insult and up to the subsequent 3 month duration | The occurance of renal recovery measured by serum creatinine , eGFR , urinary proteins and need for dialysis after the insult and up to the subsequent 3 month duration |