Factors predicting the outcome of acute renal failure in pregnancy.
OBJECTIVE
To determine the factors predicting renal outcome in patients developing acute renal failure in pregnancy.


METHODS
Descriptive cohort study.


METHODS
Study was conducted at Nephrology Unit of Sindh Institute of Urology and Transplantation, Karachi, from October 2006 to March 2007.


METHODS
Patients with acute renal failure due to complications of pregnancy, with normal size of both the kidneys on ultrasound were enrolled, and followed for a period of 60 days or until recovery of renal function. Patient's age and parity, presence of antenatal care, type of complication of pregnancy, foetal outcome and duration of oliguria were compared between patients who remained dialysis dependent and those who recovered renal function. Chi-square/Fisher's exact test and student's t-test, were used for determining the association of categorical and continuous variables with dialysis dependency.


RESULTS
The mean age was 29+/-6 years. Most patients came from rural areas of interior Sindh. Sixty eight percent did not have antenatal checkups. Antepartum haemorrhage (p=0.002) and prolonged duration of oliguria (35+/-15.7 days, p= < 0.001) were associated with dialysis dependency, which was observed in 50% of the study group.


CONCLUSIONS
Ante-partum haemorrhage and prolonged oliguria were strong predictors of irreversible renal failure. This highlights the need for early recognition and referral, and the importance of trained birth attendants and antenatal care.
Khanal
Namrata
N
Renal Services, Middlemore Hospital, Counties Manukau District Health Board, Auckland, New Zealand. namratakhanal@gmail.com
Ahmed
Ejaz
E
Akhtar
Fazal
F
D058186:Acute Kidney Injury / Q000209:etiology / Q000503:physiopathology / Q000628:therapy; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology; D006435:Renal Dialysis; D055815:Young Adult