Acute renal failure in pregnancy: Tertiary centre experience from north Indian population

  • Munna Lal Patel
  • Rekha Sachan
  • Radheshyam Radheshyam
  • Pushpalata Sachan

Abstract

Background: Obstetrical acute renal failure ARF is now a rare entity in the developed countries but still a common occurrence in developing countries. Delay in the diagnosis and late referral is associated with increased mortality. This study aimed to evaluate the contributing factors responsible for pregnancy‑related acute kidney failure, its relation with mortality and morbidity and outcome measures in these patients. Materials and Methods: Total 520 patients of ARF of various aetiology were admitted, out of these 60 (11.5%) patients were pregnancy‑related acute renal failure. Results: ARF Acute renal failure occurred in 32 (53.3%) cases in early part of their pregnancy, whereas in 28 (46.7%) cases in later of the pregnancy. Thirty‑two (53.3%) patients had not received any antenatal visit, and had home delivery, 20 (33.4%) patients had delivered in hospitals but without antenatal care and eight (13.3%) patients received antenatal care and delivered in the hospitals. Anuria was observed in 23 (38.3%) cases, remaining 37 (61.7%) cases presented with oliguria. Septicemia was present in 25 (41.7%), hypertensive disorder of pregnancy in 20 (33.3%), haemorrhage in eight (13.3%), abortion in 5 (8.3%), haemolysis elevated liver enzymes low platelets counts (HELLP) syndrome in one (1.67%) and disseminated intravascular coagulation in one (1.67%). (61.7%) patients were not dialyzed, 33 (55%) recovered normal renal function with conservative treatment. Complete recovery was observed in 45 (75%) patients, five (8.4%) patients developed irreversible renal failure. Maternal mortality was nine (15%) and foetal loss was 25 (41.7%). Conclusion: Pregnancy‑related ARF is usually a consequence of obstetric complications; it carries very high morbidity and mortality.

Keywords: Acute renal failure, hemodialysis, partial recovery, pregnancy

Nigerian Medical Journal | Vol. 54 | Issue 3 | May-June | 2013

Author Biographies

Munna Lal Patel
Department of Internal Medicine (Nephrology Unit), Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Rekha Sachan
Department of Obstetrics and Gynaecology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Radheshyam Radheshyam
Department of Critical Care, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
Pushpalata Sachan
Department of Physiology, King George’s Medical University, Lucknow
Published
2014-08-10
Section
Articles

Journal Identifiers


eISSN: 2229-774X
print ISSN: 0300-1652