title: Maternal, fetal and renal outcomes of pregnancy-associated acute kidney injury requiring dialysis.
abstract: Pregnancy-associated acute kidney injury (PAKI) is encountered frequently in developing countries. We evaluated the maternal, fetal and renal outcomes in women with PAKI who needed at least one session of dialysis. Of the total of 98 cases (mean age 28.85 ± 5.13 years; mean parity 2.65 ± 1.28) of PAKI, the most common cause of PAKI was postabortal sepsis. Eighteen patients died; those with oligoanuria, sepsis and central nervous system (CNS) involvement were at greater risk of mortality. The relative risk (RR) of neonatal mortality was lower after with full-term delivery (RR: 0.17, 95% confidence interval (CI): 0.03-0.96, P = 0.02) compared to preterm delivery. Of the 80 surviving patients, 60 (75%) patients achieved complete recovery of renal function at the end of 3 months; and of the remaining 14 had presumed (n = 4) or, biopsy-proven (n = 10) acute patchy cortical necrosis. The RR of non-recovery of renal function was high (RR: 24.7, 95% CI: 3.4- 179.5) in patients who did not recover at 6 weeks. Of the 14 patients with cortical necrosis, 3 (21.42%) became independent of dialysis at 6 months. PAKI patients should be watched for dialysis independency for 6 months.
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: A
authors.initials: A
authors.lastname: Krishna
authors.affiliation: Department of Gynecology and Obstetrics, Queen Mary's Hospital, King George Medical University, Lucknow, Uttar Pradesh, India.
authors.forename: R
authors.initials: R
authors.lastname: Singh
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: N
authors.initials: N
authors.lastname: Prasad
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: D
authors.initials: D
authors.lastname: Bhadauria
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: A
authors.initials: A
authors.lastname: Kaul
authors.affiliation: Department of Nephrology, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: R K
authors.initials: RK
authors.lastname: Sharma
authors.affiliation: Department of Gynecology and Obstetrics, General Hospital, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
authors.forename: D
authors.initials: D
authors.lastname: Kapoor
keywords: Acute cortical necrosis; acute kidney injury; dialysis; outcomes; pregnancy
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