Abstract

Observational Study

Obstetric Renal Failure: Causes, Prognosis, and Evolution

Tchich H*, Harmak K, Al-Firdaous I, Medkouri G, Mtioui N, Khayat SS, Zamd M and Benghanem M

Published: 08 August, 2024 | Volume 8 - Issue 2 | Pages: 091-094

The incidence of obstetric acute renal failure remains significant in developing countries. The aim of our study is to define the risk factors involved in the occurrence of ARF during pregnancy or during the immediate postpartum period and to evaluate its evolutionary profile in terms of epidemiology, etiopathogenesis, and therapeutic management over the years in Morocco. This is a retrospective study conducted in the maternal-infant resuscitation service of the Ibn Rochd University Hospital of Casablanca, over the period from January 2020 to August 2023, including 95 patients. The current incidence in our series over this period was 22.2%. The mean age of our population was 33 ± 7.74 years [18-43 years], 67.3% of patients were in the gestational period, compared to 33.7% in the immediate postpartum period. Fourteen patients were primiparous (8.6%), 27.4% had a history of miscarriage, and 10.7% had a history of pre-eclampsia. Oligo-anuria was initially identified in 24 patients. The most frequent etiology was pre-eclampsia (56.7%), followed by hemorrhage (27%) and sepsis (19.3%). The evolution was marked by recourse to hemodialysis in 62% of cases, with a maternal mortality of 26%. The existence of heart disease, the context of pre-eclampsia, and the use of diuretics and vasoactive drugs were significantly correlated with maternal survival. No factor was correlated with secondary recovery from ARF. The development of health structures and the optimization of screening strategies are the keywords for prevention.

Read Full Article HTML DOI: 10.29328/journal.jcn.1001133 Cite this Article Read Full Article PDF

Keywords:

Obstetric acute renal failure; Pre-eclampsia; Prognosis; Risk factor

References

  1. Ministry of Health and Social Protection. Publications [Internet]. Available from: https://www.sante.gov.ma/Publications/Pages/default.aspx
  2. High Commission for Planning of Morocco. National Survey on Population and Family Health [Internet]. Available from: https://www.hcp.ma/Enquetenationale-sur-la-population-et-la-sante-familiale_a2614/.
  3. Bokhari SRA, Inayat F, Jabeen M, Sardar Z, Saeed S, Malik AM, et al. Characteristics and outcome of obstetric acute kidney injury in Pakistan: A single-center prospective observational study. Cureus. 2018;10(9):e3362. Available from: https://doi.org/10.7759/cureus.3362
  4. Kellum JA. KDIGO clinical practice guideline for acute kidney injury. Kidney Int Suppl. 2012;2:11. Available from: https://kdigo.org/wp-content/uploads/2016/10/KDIGO-2012-AKI-Guideline-English.pdf
  5. Fakhouri F, Deltombe C. Pregnancy-related acute kidney injury in high income countries: still a critical issue. J Nephrol. 2017;30:767-771. Available from: https://doi.org/10.1007/s40620-017-0440-8
  6. Peter C, Dereu D, Casini A, Boulvain M, Savoldelli G. Acide tranexamique dans la prise en charge de l’hémorragie du postpartum: connaissances actuelles. Rev Med Suisse. 2018;4:1861-1865. Available from: https://pubmed.ncbi.nlm.nih.gov/30329233/
  7. Bouaziz M, Chaari A, Turki O, Dammak H, Chelly H, Ammar R, et al. Acute renal failure and pregnancy: A seventeen-year experience of a Tunisian intensive care unit. Ren Fail. 2017;35:121-1215. Available from: https://doi.org/10.3109/0886022x.2013.819767
  8. Gaber TZ, Shemies RS, Baiomy AA, Aladle DA, Mosbah A, Abdelhady EA, et al. Acute kidney injury during pregnancy and puerperium: An Egyptian hospital-based study. J Nephrol. 2022;34:1611-1619. Available from: https://doi.org/10.1007/s40620-021-01133-8
  9. Kabbali N, Tachfouti N, Arrayhani M, Harandou M, Tagnaouti M, Bentata Y, et al. Outcome assessment of pregnancy-related acute kidney injury in Morocco: A national prospective study. Saudi J Kidney Dis Transpl. 2015;26:619-624. Available from: https://doi.org/10.4103/1319-2442.157426
  10. Bentata Y, Housni B, Mimouni A. Acute kidney injury related to pregnancy in developing countries: Etiology and risk factors in an intensive care unit. J Nephrol. 2012;25:764-775. Available from: https://doi.org/10.5301/jn.5000058
  11. Arrayhani M, El Youbi R, Sqalli T. Pregnancy-related acute kidney injury: Experience of the nephrology unit at the University Hospital of Fez Morocco. ISRN Nephrol. 2013;2013:109034. Available from: https://doi.org/10.5402/2013/109034
  12. Hachim K, Badahi K, Benghanem M. Insuffisance rénale aiguë obstétricale: L'expérience du service de néphrologie du CHU Ibn Rochd, Casablanca. Nephrologie. 2001;1:29-31. Available from: https://pubmed.ncbi.nlm.nih.gov/11284465/
  13. Prakash J, Ganiger VC, Prakash S, Iqbal M, Kar PD, Singh U, et al. Acute kidney injury in pregnancy with special reference to pregnancy-specific disorders: A hospital-based study (2014-2016). J Nephrol. 2018;31:79-85. Available from: https://doi.org/10.1007/s40620-017-0466-y
  14. Liu Y, Bao H, Jiang Z, Huang JY, Wang SN. Pregnancy-related acute kidney injury and a review of literature in China. Intern Med. 2015;54:1695-1703. Available from: https://doi.org/10.2169/internalmedicine.54.3870
  15. Colmant C, Frydman R. Are there any pregnancies and deliveries at low risk? Gynecol Obstet Fertil. 2009;37:195-199. Available from: https://doi.org/10.1016/j.gyobfe.2008.12.001
  16. Cooke WR, Hemmila UK, Craik AL, Mandula JC, Mvula P, Msusa A, et al. Incidence, aetiology and outcomes of obstetric-related acute kidney injury in Malawi: A prospective observational study. BMC Nephrol. 2018;19:25. Available from: https://doi.org/10.1186/s12882-018-0824-6
  17. Shemies RS, Gaber TZ, Baiomy A, Aladle AD, Mosbah A, El-Said A, et al. Angiogenic markers predict kidney injury and obstetric complications in women with preeclampsia and pregnancy-related acute kidney injury. Ther Apher Dial. 2022;26:306-315. Available from: https://doi.org/10.1111/1744-9987.13633

Figures:

Similar Articles

Recently Viewed

Read More

Most Viewed

Read More

Help ?