title: Spectrum of renal injury in pregnancy-induced hypertension: Experience from a single center in India.
abstract: Pregnancy-induced hypertension (PIH) is a known complication of late pregnancy and is an important cause of maternal and fetal morbidity and mortality. Data on clinical profile, especially renal profile of preeclampsia and eclampsia in Indian women are lacking. The aim of our study was to examine the renal profile and clinical outcomes of patients diagnosed with PIH in our institution with a focus on the spectrum of acute kidney injury (AKI). In this prospective, observational study, 347 patients with a diagnosis of preeclampsia-eclampsia, who were undergoing treatment at the M. S. Ramaiah Medical College, were included in the study. The study duration was from 2010 to 2014. Details regarding epidemiologic data, obstetric data, laboratory parameters as well as maternal, renal, and fetal outcomes were noted. Patients with preexisting hypertension, diabetes mellitus, or chronic kidney disease were excluded from analysis. The overall incidence of preeclampsia was 3.4%. Hemolysis, elevated liver enzymes, and low platelets syndrome was seen in 31 patients (9%); 56 patients (19%) had AKI with a mean serum creatinine of 3.2 mg/dL and mean proteinuria of 2.8 g/24 h. Nineteen patients required dialysis. Persistent renal failure was seen in 2.5% of the cohort. Maternal mortality was 2.5%, largely secondary to sepsis. Primiparity was a major risk factor. In this study, we found a low rate of preeclampsia in a low-to-moderate risk cohort, with an incidence of AKI and maternal mortality consistent with reported literature.
authors.affiliation: Department of Nephrology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Mahesh
authors.initials: M
authors.lastname: Eswarappa
authors.affiliation: Department of Nephrology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Madhyastha
authors.initials: M
authors.lastname: Rakesh
authors.affiliation: Department of Nephrology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Puri
authors.initials: P
authors.lastname: Sonika
authors.affiliation: Department of Pharmacy, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Snigdha
authors.affiliation: Department of Pharmacy, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: M
authors.initials: M
authors.lastname: Midhun
authors.affiliation: Department of Pharmacy, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: K
authors.initials: K
authors.lastname: Kaushik
authors.affiliation: Department of Nephrology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Gurudev Konana
authors.initials: GK
authors.lastname: Chennabasappa
authors.affiliation: Department of Nephrology, M. S. Ramaiah Medical College, Bengaluru, Karnataka, India.
authors.forename: Bande
authors.initials: B
authors.lastname: Sujeeth
mesh_terms: D058186:Acute Kidney Injury / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D000328:Adult; D015415:Biomarkers / Q000097:blood; D001792:Blood Platelets; D003404:Creatinine / Q000097:blood; D004798:Enzymes / Q000097:blood; D005260:Female; D006461:Hemolysis; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D010298:Parity; D011225:Pre-Eclampsia / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology / Q000628:therapy; D011247:Pregnancy; D011379:Prognosis; D011446:Prospective Studies; D011507:Proteinuria / Q000453:epidemiology; D006435:Renal Dialysis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D015415:Biomarkers; D004798:Enzymes; D003404:Creatinine