title: Acute renal failure and pregnancy: a seventeen-year experience of a Tunisian intensive care unit.
abstract: OBJECTIVE
  To describe the epidemiologic features of acute renal failure related to pregnancy (PRARF) and to evaluate its prognostic impact.
  
  
  METHODS
  Retrospective study conducted in a Tunisian intensive care unit over a period of 17 years (1995-2011). Women were included if they were more than 20 weeks pregnant and were admitted to the ICU during pregnancy or immediately (<7 d) post partum. PRARF was defined by a serum creatinine level >0.8 mg/dL and was classified as mild (0.9 to 1.4 mg/dL), moderate (1.5 to 2.9 mg/dL) or severe (>3 mg/dL).
  
  
  RESULTS
  Five hundred and fifty patients were included. Mean age was 31 ± 6 years. Mean SOFA score was 4 ± 3. PRARF was diagnosed in 313 patients (56.9%). ARF was mild in 215 cases (39.1%), moderate in 65 cases (11.8%) and severe in 33 cases (6%). Main causes leading to this complication were preeclampsia (66.5%) and acute hemorrhage (27.8%). Only two patients (0.4%) developed chronic renal failure and needed long-term dialysis. Patients who developed this complication had higher SOFA score (4.7 ± 3.5 vs. 3.2 ± 2.1; p < 0.001). Thirty-three patients (6%) died in the ICU. The rate of ICU mortality was significantly higher in patients with PRARF (9.3 vs. 1.7%; p < 0.001).
  
  
  CONCLUSIONS
  PRARF is associated with higher mortality. Thus, appropriate monitoring of pregnancies is needed in order to prevent its onset by an early and prompt management of the underlying risk factors.
authors.affiliation: Intensive Care Unit, Habib Bourguiba University Hospital , Tunisia.
authors.forename: Mounir
authors.initials: M
authors.lastname: Bouaziz
authors.forename: Anis
authors.initials: A
authors.lastname: Chaari
authors.forename: Olfa
authors.initials: O
authors.lastname: Turki
authors.forename: Hssan
authors.initials: H
authors.lastname: Dammak
authors.forename: Hedi
authors.initials: H
authors.lastname: Chelly
authors.forename: Rania
authors.initials: R
authors.lastname: Ammar
authors.forename: Abdennour
authors.initials: A
authors.lastname: Nasri
authors.forename: Najla
authors.initials: N
authors.lastname: Ben Algia
authors.forename: Mabrouk
authors.initials: M
authors.lastname: Bahloul
authors.forename: Chokri
authors.initials: C
authors.lastname: Ben Hamida
mesh_terms: D058186:Acute Kidney Injury / Q000401:mortality* / Q000628:therapy; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D007362:Intensive Care Units / Q000706:statistics & numerical data; D008875:Middle Aged; D011247:Pregnancy; D011248:Pregnancy Complications / Q000401:mortality* / Q000628:therapy; D012189:Retrospective Studies; D014416:Tunisia / Q000453:epidemiology; D055815:Young Adult