scholarly journals A study of pregnancy related acute kidney injury and its outcome at a tertiary care centre, civil hospital, Ahmadabad, Gujarat, India

2019 ◽  
Vol 8 (10) ◽  
pp. 4020
Author(s):  
Komal K. Agrawal ◽  
Mahima Jain
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Causative Factor ◽  
Partial Recovery ◽  
Loss Of Function ◽  
Contributing Factors ◽  
Tertiary Care Centre ◽  
Stage Renal Disease ◽  
In Pregnancy

Background: Pregnancy related acute kidney injury (PRAKI) is acute kidney injury occurring during pregnancy, labour, delivery, and/or postpartum period. Proper management of PRAKI is challenging because (i) both maternal and fetal health must be considered and (ii) the cardiovascular and renal adaptations of pregnancy add to the complexity of diagnosis and management. A multi discipilinary team is often needed to optimize all aspects of the pregnant women’s care.Methods: To study association and contributing factors in pregnancy related Acute Kidney injury, a retrospective study of 39 cases of acute kidney injury complicating pregnancies was carried out in department of obstetrics and gynaecology, B. J. Medical college over a period of 6 months, and results were studied and analysed. Etiological-factors, associated liver pathology, coagulation abnormality, thrombocytopenia, sepsis, recovery status and fetomaternal outcome were studied and results were tabulated. AKI was analysed in terms of maximal stage of renal injury attained as per risk, injury, failure, loss of function, and end-stage renal disease (RIFLE) criteria.Results: The incidence of ARF in pregnancy was found to be 0.3%. Hypertension and its related complications were the most common causative factor. 59.5% of cases required hemodialysis and except for 6 cases (14.3%) all had complete or at least partial recovery from failure.Conclusions: AKI complicating pregnancies are not uncommon in tertiary care centres. If recognized and treated promptly, recovery is assured in majority of 85.7% of cases. Early identification and prompt management of pre-eclampsia and sepsis can prevent majority of ARF cases.

scholarly journals Acute kidney injury and its outcome in obstetrics

2020 ◽  
Vol 9 (6) ◽  
pp. 2508
Author(s):  
Dipal C. Shah ◽  
Babulal S. Patel ◽  
Akshay C. Shah ◽  
Shashwat K. Jani ◽  
Saumya P. Agrawal ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Placenta Previa ◽  
Kidney Injury ◽  
Causative Factor ◽  
Loss Of Function ◽  
Contributing Factors ◽  
Early Management ◽  
Study Association ◽  
Stage Renal Disease ◽  
End Stage

Background: Acute kidney injury occurring during pregnancy, labour, delivery, and/or postpartum period. Proper management of AKI (acute kidney injury) is challenging because (i) both maternal and fetal health must be considered and (ii) the cardiovascular and renal adaptations of pregnancy add to the complexity for management.Methods: The objective of this study was to study association and contributing factors in AKI, a retrospective study of 20 cases of AKI complicating pregnancies carried out in department of obstetrics and gynecology, SVPIMSR over a period of 12 months and results were studied and analysed. Etiological factors, associated liver pathology, coagulation abnormality, thrombocytopenia, sepsis, recovery status and fetomaternal outcome were studied and tabulated. AKI was analysed in terms of maximal stage of renal injury attained as per risk, injury, failure, loss of function, and end-stage renal disease (RIFLE) criteria.Results: The incidence of ARF (acute renal failure) in pregnancy was about 0.3%. Hypertensive disorders were the major causative factor. Amongst the 20 cases, 8 cases were referred from outside and two of them died. Total 5 of 20 cases required hemodialysis and two of them had partial recovery.Conclusions: AKI complicating pregnancies are not uncommon. If recognized and treated promptly, recovery is assured in majority of cases. Early identification and prompt management of pre-eclampsia and sepsis can prevent majority of cases. Ultrasonography revelation of placenta previa or abruption helps in early management eventually decreases the chances of bleeding which is one of the causes of AKI (pre-renal cause).

Acute Kidney Injury

2020 ◽  
Author(s):  
Aileen Ebadat ◽  
Eric Bui ◽  
Carlos V. R. Brown
Keyword(s):  
Acute Kidney Injury ◽  
Renal Failure ◽  
Kidney Injury ◽  
Acute Kidney Injury Network ◽  
Loss Of Function ◽  
Management Algorithm ◽  
Consensus Statements ◽  
Definition Of ◽  
Stage Renal Disease ◽  
End Stage

Acute renal failure definitions have changed dramatically over the last 5 to 10 years as a result of criteria established through the following consensus statements/organizations: RIFLE (Risk, Injury, Failure, Loss of function, End stage renal disease), AKIN (Acute Kidney Injury Network), and KDIGO (Kidney Disease: Improving Global Outcomes). In 2002, the Acute Dialysis Quality Initiative was tasked with the goal of establishing a consensus statement for acute kidney injury (AKI). The first order of business was to provide a standard definition of AKI. Up to this point, literature comparison was challenging as studies lacked uniformity in renal injury definitions. Implementing results into evidence-based clinical practice was difficult. The panel coined the term “acute kidney injury,” encompassing previous terms, such as renal failure and acute tubular necrosis. This new terminology represented a broad range of renal insults, from dehydration to those requiring renal replacement therapy (RRT). This review provides an algorithmic approach to the epidemiology, pathophysiology, diagnosis, prevention, and management of AKI. Also discussed are special circumstances, including rhabdomyolysis, contrast-induced nephropathy, and hepatorenal syndrome. Tables outline the AKIN criteria, most current KDIGO consensus guidelines for definition of AKI, differential diagnosis of AKI, agents capable of causing AKI, treatment for specific complications associated with AKI, and options for continuous RRT. Figures show the RIFLE classification scheme and KDIGO staging with prevention strategies. This review contains 1 management algorithm, 2 figures, 6 tables, and 85 references. Keywords: Kidney, renal, KDIGO, azotemia, critical, urine, oliguria, creatinine, dialysis

scholarly journals Acute kidney injury requiring dialysis in obstetric patients: management and clinical outcome in case series of 30 patients in a tertiary care centre

2017 ◽  
Vol 6 (7) ◽  
pp. 2997
Author(s):  
Molina U. Patel ◽  
Yuvraj Jadeja ◽  
Niket Patel ◽  
Nayana Patel ◽  
Smruti Vaishnav ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Case Series ◽  
Kidney Injury ◽  
Therapeutic Interventions ◽  
Risk Category ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Significant Difference ◽  
The Impact

Background: Acute Kidney Injury is a common medical problem affecting approximately 5% of all hospitalized and 30% of critically ill patients. The incidence in obstetric patients ranges from 1 in 2000 to 1 in 25000 pregnancies. In India till date, the impact of AKI on fetomaternal outcome and pertaining therapeutic interventions is only sparsely studied.Methods: It is a retrospective cross-sectional study. All obstetric patients with AKI on dialysis, admitted to Shree Krishna Hospital, a tertiary care hospital in Karamsad village in Gujarat from January 2013 to August 2015. Multivariate statistical analysis of clinical and laboratory parameters was performed using SPSS program to obtain the results.Results: The incidence of dialysis was 1.6%. HELLP syndrome and pre-eclampsia (80%) was found to be the most common etiology of AKI followed by Congestive cardiac failure (34.5%), hemorrhage and sepsis in 30% resp. All patients were admitted to ICU care. No significant difference was found between SAP II and SOFA monitoring system. Mechanical ventilation was done to support 53.3% and inotropic support was needed by 56.7% patients. According to the RIFLE criteria, majority of the patients fall under risk category followed by injury. 18% of the patients developed End Stage Renal Disease.Conclusions: In view of the multifaceted etiologies and complexity of management of AKI, a multi-disciplinary approach involving nephrologist, intensivists, obstetricians and neonatologists is extremely important.

Clinical Profile of Cases of Acute Kidney Injury in a Tertiary Care Centre

2016 ◽  
Author(s):  
Gp Capt (Dr) V.R. Mujeeb A ◽  
◽  
Maj (Dr) Yatharth Dixit ◽  
Brig (Dr) Arun Tyagi ◽  
◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Clinical Profile ◽  
Care Centre ◽  
Tertiary Care Centre

scholarly journals A prospective study of clinical characteristics and outcomes of acute kidney injury in a tertiary care Centre

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Su Hooi Teo ◽  
Kian-Guan Lee ◽  
Riece Koniman ◽  
Alvin Ren Kwang Tng ◽  
Zhong Hong Liew ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Prospective Study ◽  
Clinical Characteristics ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
A Prospective Study

scholarly journals Acute kidney injury in tropical acute febrile illness in a tertiary care centre--RIFLE criteria validation

2010 ◽  
Vol 26 (2) ◽  
pp. 524-531 ◽  
Author(s):  
G. Basu ◽  
A. Chrispal ◽  
H. Boorugu ◽  
K. G. Gopinath ◽  
S. Chandy ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Febrile Illness ◽  
Acute Febrile Illness ◽  
Care Centre ◽  
Tertiary Care Centre ◽  
Rifle Criteria

scholarly journals Cumulative fluid accumulation is associated with the development of acute kidney injury and non-recovery of renal function: a retrospective analysis

Critical Care ◽  
2019 ◽  
Vol 23 (1) ◽  
Author(s):  
Jing Zhang ◽  
Siobhan Crichton ◽  
Alison Dixon ◽  
Nina Seylanova ◽  
Zhiyong Y. Peng ◽  
...  
Keyword(s):  
Risk Factors ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Fluid Balance ◽  
Tertiary Care ◽  
Kidney Injury ◽  
Renal Recovery ◽  
Partial Recovery ◽  
Factors Associated ◽  
Cumulative Fluid Balance

Abstract Background Acute kidney injury (AKI) is common in patients in the intensive care unit (ICU) and may be present on admission or develop during ICU stay. Our objectives were (a) to identify factors independently associated with the development of new AKI during early stay in the ICU and (b) to determine the risk factors for non-recovery of AKI. Methods We retrospectively analysed prospectively collected data of patients admitted to a multi-disciplinary ICU in a single tertiary care centre in the UK between January 2014 and December 2016. We identified all patients without AKI or end-stage renal failure on admission to the ICU and compared the outcome and characteristics of patients who developed AKI according to KDIGO criteria after 24 h in the ICU with those who did not develop AKI in the first 7 days in the ICU. Multivariable logistic regression was applied to identify factors associated with the development of new AKI during the 24–72-h period after admission. Among the patients with new AKI, we identified those with full, partial or no renal recovery and assessed factors associated with non-recovery. Results Among 2525 patients without AKI on admission, the incidence of early ICU-acquired AKI was 33.2% (AKI I 41.2%, AKI II 35%, AKI III 23.4%). Body mass index, Sequential Organ Failure Assessment score on admission, chronic kidney disease (CKD) and cumulative fluid balance (FB) were independently associated with the new development of AKI. By day 7, 69% had fully recovered renal function, 8% had partial recovery and 23% had no renal recovery. Hospital mortality was significantly higher in those without renal recovery. Mechanical ventilation, diuretic use, AKI stage III, CKD, net FB on first day of AKI and cumulative FB 48 h later were independently associated with non-recovery with cumulative fluid balance having a U-shape association. Conclusions Early development of AKI in the ICU is common and mortality is highest in patients who do not recover renal function. Extreme negative and positive FB were strong risk factors for AKI non-recovery.

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