Pattern and Clinical Outcome of Pregnancy Related Acute Kidney Injury Referral to Nephrology Services in Tertiary Care Hospital at Islamabad Capital Territory
DOI:
https://doi.org/10.70749/ijbr.v3i6.3050Keywords:
Acute Kidney Injury, Pregnancy, Acute Tubular Necrosis, Post-partum Hemorrhage, Maternal Mortality, Dialysis.Abstract
Background: Pregnancy-related acute kidney injury (PR-AKI) is a critical obstetric complication associated with significantly increased risks of maternal and fetal mortality, particularly in low- and middle-income countries (LMICs). Disparities in healthcare resources lead to a high incidence in regions like South Asia, yet local data on its prevalence, risk factors, and patterns remain scarce. So, purpose of this study is to determine the pattern and clinical outcome in patients of pregnancy related acute kidney injury. Methods: This descriptive longitudinal study was conducted at the nephrology department of a tertiary care hospital in Islamabad, Pakistan from 31st December 2024 to 15 April 2025. 137 pregnant or postpartum women with PR-AKI, diagnosed per KDIGO criteria, were enrolled via purposive sampling. Demographic, clinical, and outcome data were collected and analyzed using SPSS version 25. Results: The mean age of participants was 31.46 years, with the majority (81.8%) presenting in the third trimester. The most common pattern of clinical presentation was anuria (75.2%). Post partum hemorrhage was the predominant risk factor (63.5%) while preeclampsia/eclampsia (10.22%), sepsis (3.65%), and others (HELLP, TMA) 22.63% were reported. Dialysis was required in 65.0% of cases. While complete renal recovery was achieved in 83.2% of patients, mortality was 12.4% and 4.4% developed ESRD. Statistical analysis revealed significant associations between the type of complication and both the mode of delivery (p=0.011) and the need for dialysis (p<0.001). Furthermore, patient outcomes were significantly associated with the place of delivery (p=0.026) and gestational age (p=0.048). Conclusion: PR-AKI in this study is primarily a complication of the third trimester, driven largely by post-partum hemorrhage, sepsis and eclampsia leading to acute tubular necrosis and anuria, and frequently requiring dialysis. Although recovery rates are high, significant mortality persists. The findings underscore the urgent need for enhanced antenatal monitoring, improved management of obstetric hemorrhage, and better access to facility-based deliveries to mitigate the burden of PR-AKI in resource-stratified settings.
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