Kidney Week

Abstract: FR-PO029

Clinical Features and Outcomes of Pregnancy-Related AKI: A Single Tertiary Center Study

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Ghonimi, Tarek Abdellatif, Zagazig University Faculty of Human Medicine, Zagazig, Egypt

Tarek Abdellatif Ghonimi, MBBS, MD, FASN

• Elsayed, Islam Ali, Zagazig University Faculty of Human Medicine, Zagazig, Egypt

Islam Ali Elsayed, MD, MBChB, MS

• Abd El-Hameed, Ayman Riyadh, Zagazig University Faculty of Human Medicine, Zagazig, Egypt

Ayman Riyadh Abd El-Hameed, MD

Background

Pregnancy-related acute kidney injury (Pr-AKI) is a major cause of maternal and fetal morbidity and mortality in developing countries. The aim of our study was to study the clinical characteristics and outcomes of patients with Pr-AKI at our center.

Methods

This prospective study at Zagazig University Hospital, Egypt, from October 1, 2023, to March 1, 2024, included patients with post-partum AKI. These women were compared to a matched cohort of healthy pregnant women without pre-existing AKI.Multivariate analysis is used to identify risk factors.

Results

Out of 900 pregnant patients who delivered during the study period, 52 patients developed post-partum AKI with incident of 5.7%. The majority were multiparous( 59.6%), and most delivered by cesarean section (67.3%).The most common cause of AKI is preeclampsia (51.9%) , followed by ante-partum hemorrhage (40.4%) and HEELP syndrome (36.5%). Stage 3 AKI (KDIGO classification) was the most prevalent occurring in 23% of cases. Maternal death occurred in 13.5% of cases, while fetal death was 17.3%. Follow- up showed that 42.3% had complete recovery, 30.7% CKD and 13.4% remained dialysis-dependent. Risk factors for AKI included high WBC, low Hb, low platelets, and high bilirubin levels, with p-values of 0.004, <0.0001, and 0.031, respectively. Additionally, nulliparous women had significantly lower odds of developing AKI (0.248, p = 0.017). However, the significance of these risk factors disappeared in multivariate analysis.

Conclusion

Post-partum AKI is a relatively common pregnancy complication with significant maternal and fetal mortality risks. Preeclampsia and ante-partum hemorrhage are major risk factors. Larger, long-term follow-up studies are recommended to confirm these findings.

Funding

• Private Foundation Support