2018, Number 4
Rev Mex Anest 2018; 41 (4)
Moreno-Santillán AA, Díaz de León-Ponce MA, Briones-Vega CG, Martínez-Adame LM, Gómez BTE, Briones-Garduño JC
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ABSTRACTObjective: To provide the most recent and relevant scientific evidence about definitions, classification, diagnosis and management of acute renal failure during pregnancy and puerperium. Research methodology: We searched databases in PubMed, The Cochrane Library, OVID, Science Direct, Google Scholar, Artemisa, LILACS and IMBIOMED from 2005 to 2018 with the following keywords: acute renal failure, acute renal disease, acute kidney injury, pregnancy, obstetrics. Inclusion criteria were systematic reviews, meta-analysis, clinical controlled trials, and articles with evidence-based medicine methodology with strong recommendations. We included 31 articles. Results: Acute renal failure (ARF) in obstetrics is a rare but severe complication that can increase the morbidity and mortality on both mother and fetus. The clinical study of the obstetric patient must take into consideration normal physiologic changes of pregnancy that increase the complexity of diagnosing acute renal failure. The etiology of renal failure in the pregnant patient is divided into pre-renal, intra-renal, and post-renal causes; management focuses on the underlying cause. Conclusions: A concerted effort is needed to standardize the definition and classification of ARF in obstetrics. Nevertheless, the most important issue about ARF during pregnancy is the appropriate multidisciplinary treatment based on the best clinical evidence.