title: Outcome assessment of pregnancy-related acute kidney injury in Morocco: A national prospective study.
abstract: Acute kidney injury (AKI) is a rare but life-threatening complication of pregnancy. The aim of this paper is to study the characteristics of acute AKI in pregnancy and to emphasize on its management modalities in Moroccan hospitals. This is a national prospective study performed over six months from July 1 to December 31 2010 on AKI developing in pregnant patients, both preand post-partum period. Patients with pre-existing kidney disease were excluded from the study. Outcome was considered unfavorable when complete recovery of renal function was not achieved and/or maternal death occurred. Forty-four patients were included in this study. They were 29.6 ± 6 years old and mostly illiterate (70.6%). Most AKI occurred in the post-partum period, with 66% of the cases occurring in those who did not receive antenatal care. The main etiologies were pre-eclampsia (28 cases), hemorrhagic shock (six cases) and septic events (five cases). We noted three cases of acute fatty liver, one case of obstructive kidney injury and one case of lupus nephritis. Hemodialysis was necessary in 17 (38.6%) cases. The outcome was favorable in 29 patients. The maternal mortality rate was 11.4%. Two poor prognostic factors were identified: Age over 38 years and sepsis. AKI is a severe complication of pregnancy in developing countries. Its prevention necessitates the improvement of the sanitary infrastructure and the establishment of the obligatory antenatal care.
authors.affiliation: Nephrology Department, Hassan II University Hospital, Fez, Morocco.
authors.forename: Nadia
authors.initials: N
authors.lastname: Kabbali
authors.forename: Nabil
authors.initials: N
authors.lastname: Tachfouti
authors.forename: Mohammed
authors.initials: M
authors.lastname: Arrayhani
authors.forename: Mustapha
authors.initials: M
authors.lastname: Harandou
authors.forename: Mounia
authors.initials: M
authors.lastname: Tagnaouti
authors.forename: Yassamine
authors.initials: Y
authors.lastname: Bentata
authors.forename: Inass
authors.initials: I
authors.lastname: Laouad
authors.forename: Benyounes
authors.initials: B
authors.lastname: Ramdani
authors.forename: Rabia
authors.initials: R
authors.lastname: Bayahia
authors.forename: Zouhair
authors.initials: Z
authors.lastname: Oualim
authors.forename: Tarik Sqalli
authors.initials: TS
authors.lastname: Houssaini