Estrada-Gutiérrez A, Maya-Contreras C, Aguilar-Arciga TG, García-Gómez A, Barriga-Ferreyra P

Language: Spanish
References: 8
Page: 79-83
PDF size: 148.86 Kb.

ABSTRACT

Objective: To define the prevalence and associated factors of acute renal injury in pregnancy (PR-AKI) in the Intensive Care Unit (ICU) of the Women's Hospital, Morelia, Michoacán, Mexico. Material and methods: Retrospective, cross-sectional and descriptive study from January 2013-August 2018. Ambit: Intensive Care Unit of the Women's Hospital. Patients: We reviewed 213 files of complicated obstetric patients. Inclusion criteria: complicated obstetric patients that merit admission to the ICU, patients who met criteria for LRA. Exclusion criteria: patients with chronic. Main variables of interest: Complicated obstetric patients (preeclampsia, eclampsia, HELLP syndrome, hemorrhagic shock and sepsis). It was investigated if they developed PR-AKI. Results: 154 complicated obstetric patients were included; an average of 25.6p ± 1.6 per year. 36% had a diagnosis of eclampsia; 35.3% pre-eclampsia; 29.3% HELLP syndrome; 19.3% obstetric hemorrhage, 10% sepsis. Association of PR-AKI with HELLP syndrome (p = 0.0003) and pre-eclampsia (p = 0.01) was demonstrated. A subdiagnosis of 36.7% was found when searching for PR-AKI using the RIFLE and AKI criteria (p = 0.000007). Of the patients with PR-AKI grade 3, 20% required continuous renal replacement therapy. Conclusions: Renal injury associated with complicated pregnancy has a prevalence of 6.7%. The complications that most develop PR-AKI are HELLP syndrome and preeclampsia. PR-AKI is underdiagnosed.

REFERENCES

1. Van Hook JW. Acute kidney injury during pregnancy. Clin Obstet Gynecol. 2014;57(4):851-61. doi: 10.1097/GRF.0000000000000069.

2. 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. doi: 10.5402/2013/109034.

3. Bentata Y, Housni B, Mimouni A, Azzouzi A, Abouqal R. Acute kidney injury related to pregnancy in developing countries: etiology and risk factors in an intensive care unit. Indian J Nephrol. 2017;27(2):113-117. doi: 10.4103/0971-4065.194394.

4. Carrillo ER, Castro PJ. Escala RIFLE. Fundamentos y su impacto en el diagnóstico, pronóstico y manejo de la lesión renal aguda en el enfermo grave. Rev Asoc Mex Med Crit y Ter Int. 2009;23(4):241-244.

5. Sibai BM. The HELLP syndrome (hemolysis, elevated liver enzymes, and low platelets): much ado about nothing? Am J Obstet Gynecol. 1990;162(2):311-316.

6. CENETEC. Detección, diagnóstico y tratamiento de enfermedades hipertensivas del embarazo. (1 de Enero de 2017) Recuperado el 28 de Mayo de 2019, de CENETEC: http://www.cenetec-difusion.com/CMGPC/IMSS-058-08/ER.pdf.

7. Ali A, Ali MA, Ali UM, Mohammad S. Hospital outcomes of obstetrical-related acute renal failure in a tertiary care teaching hospital. Ren Fail. 2011;33(3):285-290.

8. Rao S, Jim B. Acute kidney injury in pregnancy: the changing landscape for the 21st century. Kidney Int Rep. 2018;3(2):247-257. doi: 10.1016/j.ekir.2018.01.01.